Application Form for Medical Courses

Educational / Qualification :
Details Of Examination Fee (UTR No./DD No.) :
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Declaration :

I hereby declare that all the particulars stated in this Application Form are true to the best of my knowledge and belief. I have read and understood all provision of admission and agree to abide by them. I also affirm that I fulfill the eligibility requirements for the courses applied. In event of submission of fraudulent, incorrect or untrue information or suppression or distortion of any fact likes educational qualification, marks, nationality etc. I understand that my admission/ degree is liable for cancellation. I further understand that my admission is purely provisional subject to the verification of the eligibility conditions.