Application Form for MD/MS Admission

Application Form for MD/MS Admission, NEET 2022

Name of the Canditate (As given in Class X Certificate)

First Name :

Middle Name

Surname

E-Mail ID:

Date of Birth:

As on 31st December 2021:

Father's Name:

PAN No / Aadhar No:

Occupation:

Father Contact No:

Mother's Name:

Occupation:

Mother Contact No:

E-mail ID of Parent:

Permanent Address:

Pin No:

Mobile:

Tel No:

Present Address

Pin No:

Mobile:

Tel No:

Place of Birth:

Nationality

Category

Gender*

Details of Qualifying Exam:

Name of Medical College:

Name of University:

Medical Registration Number & State:

Year of Passing:

Deails of NEET :

Upload Photo (file type must be in jpg,png,pdf and size should be maximum 1.5 MB)

All formalities related to Reporting, document checking and verfication (including prescribed eligibility criteria) along with deposition of fee prescribed by the college, required bonds etc. and other documents as listed in intruction booklet are to be completed as per the norms laid down by the Counseling Board and the University. Failure to comply may lead to Cancelation of allotment.

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Application Form for MD/MS Admission

Application Form for MD/MS Admission, NEET 2022