Application form for Admission to Medical Institute

Choose Your Study Subjects Choose Diploma in Sanitary Inspector Diploma in Health Inspector Diploma in X-Ray Technician

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Name

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date of birth

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community

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caste

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nationality

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religion

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name of father/gardian/husband

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name of mother

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address for communication

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are u son / daughter of ex service man

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name & location(district) of institution last studied

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qualifying examination passed

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subjects (qualifying examination) as per marks sheet

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marks max

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marks obtained

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month & year of passing

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Reg. No

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No. of Attempts

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percentage

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marital status

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occupation of father/gurdian/husband

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anual income of the father/gurdian/husband

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Phone Number

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Enter your Valid Email For get copy of the admission form you submited details acknowledgement

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place

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Today Date

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