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STUDENT REGISTRATION FORM
Registration No.:
Reg. Date:
Student Name:
D.O.B:
Father's Name:
Financial Year:
Mother's Name:
Course:
--Select Course--
A.N.M.
B.Ed
BA.LL.B
CMS&ED
D.M.L.T.
D.PHARMA AYURVEDA
D.PHARMA UNANI
D.PHARMACY
Diploma in Optometry
ELECTRICIAN
FITTER
G.N.M.
G.N.M. ayurveda
HEALTH SANITARY INSPECTOR
HOSPITAL HOUSE KEEPING
LL.B
P.G.D.M.
PANCHKARMA
PHYSIOTHERAPY
PHYSIOTHERAPY TECHNICIAN
SANITATION
ULTRA SOUND TECHNICIAN
Contact Address:
Income Certificate:
YES
NO
N/A
Domicile:
YES
NO
N/A
Permanent
Caste Certificte:
YES
NO
N/A
State:
Andaman and Nicobar Islands
Andra Pradesh
Arunachal Pradesh
Assam
Bihar
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Chhattisgarh
Dadar and Nagar Haveli
Daman and Diu
Delhi
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Gujarat
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City:
A/c No.:
Gender:
MALE
FEMALE
OTHER
IFSC Code:
Nationality:
Age as on:
Religion :
Hinduism
Islam
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Zoroastrianism
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Label
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Student Photo:
Category:
SC
ST
GEN
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MINORITY
EWS
What's App. No.:
Mobile No.
Aadhar No.:
Pan No.:
Status:
Pending
Pending
Approved
Reject
Enrolment No.:
Narration:
College Code:
College Name:
Exam Passed
Board/University
School/College
Roll No.
Pass Year
Marks Obt.
Total Marks
%
Subject Stream
10th
12th
Graduation
Other
Registration Fee:
Rs. 300/-
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