FACULTY OF AYURVED

Application Form for Institutional MOPUP Round B.A.M.S. Course 2018-19


PERSONAL INFORMATION

Name of the Candidate *
(as it appears in S.S.C. Board Certificate)
Fathers Name *
Mobile No.*
Email*
Date of Birth *
Gender *
Religion *
Nationality*
Aadhar Card No. *
Caste & Sub Caste *

Address for Correspondence

Address (House no. street/ area etc.) *
Village/Tehsil *
City *
District *
State *
PIN Code *

Previous Academic Record

Name of Previous School/College *
H.S.S.C./XIIth marks as per Mark Sheet *
English *
Physics (P) *
Chemistry (C) *
Biology (B) *
Total PCB Marks *
PCB Percentage *

NEET-Year & Month of Passing *
NEET-2018 Roll No. *
NEET-2018 Marks Obtained *
NEET-2018 All India Rank *
(Overall Rank )

For Office Use only

Verified that he/ she is eligible for admission to ................................................................. for the academic session 2018-19.


Dean
Authorized Signatory