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Note - This form is to be filled only after successful online registration.
यह फॉर्म सफल
ऑनलाइन
पंजीकरण के बाद ही भरा जाएगा
Student Admission Form
Registration Number
*
Candidate Full Name (in BLOCK LETTERS)
*
Father's Name
*
Mother's Name
*
Date of Birth
*
Aadhaar Number
*
Email ID
*
Mobile Number
*
WhatsApp Number
*
Correspondence Address
*
Permanent Address
*
Gender
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Female
Other
Category
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General
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ST
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*
Select Course Applying For
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Radiology Technician
Dental Lab Technician
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Physiotherapy Technician
First AID
Photograph
*
Signature
*
10th Marksheet
*
12th Marksheet (Optional)
Aadhaar Card (Front Side)
*
Aadhaar Card (Back Side)
*
Category Certificate
Course Fee payment screenshot
I affirm that all the details furnished above are accurate and complete to the best of my knowledge. I have carefully read and understood the fee refund policy as stated.
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