Student Registration Form
Name
*
Course
*
Select
G.N.M.(AYURVEDA)
D.PHARMA(AYURVEDA)
FITTER
DENTAL LAB TECHNICIAN
RADIOLOGY TECHNICIAN(X-RAY)
DIPLOMA IN PHYSIOTHERAPY
DIPLOMA IN OPTOMETRY
LL.B.
B.A.LL.B.
A.N.M.
G.N.M.
D.PHARMA
B.PHARMA
College
*
Date Of Birth
*
Mobile No.
*
Email ID
*
Nationality
*
Gender
*
Please Select
MALE
FEMALE
OTHER
Caste
*
Please Select
GEN
OBC
SC/ST
OTHER
Aadhar Card No
*
Income Certificate No
Caste Certificate No
Father`s Name
*
Father`s Mobile No.
*
Father`s Income
*
Mother`s Name
*
Correspondence Address
*
Pincode
*
Permanent Address
*
Pincode
*
Student Photo (less than or equal to 100kb)
*
Student Signature (less than or equal to 100kb)
*
Academics Data
Academics
Name of Exam Board / University
Subjects
Roll No
Year of Passing
Total Marks
% of Marks
High School
*
Intermediate
*
Graduation
Post Graduation
Other Certification
Counselling Details
If you are selected through counselling, then fill the below detail
*
Roll No
Rank
Examine Body
Register
Application Status
