Applicant Details
Choose Your Course
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D. Pharmacy
Applicant Name (As Per Certificate)
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Applicant Father's Name
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Applicant Mother's Name
Name Of Guardian (In Absence Of Parents)
Applicant Permanent Address
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Address
District
PIN
Applicant Present Address
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Address
District
PIN
Applicant Mobile Number
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Applicant WhatsApp Number
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Applicant Email ID
Guardian Mobile Number
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Guardian WhatsApp Number
Guardian Email ID
Applicant Date Of Birth
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DD slash MM slash YYYY
Nationality
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Religion
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Gender
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Male
Female
Category
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SC
ST
OBC-A
OBC-B
PH
GENERAL
Marital Status
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Select Status
Unmarried
Married
Divorced
Widowed
Language Known
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Academic Qualification Record
10th Standard
Board
Institute Name
Year Of Passing
Subjects
Full Marks
Marks Obtained
% Of Marks
10+2 Standard
Council
Institute Name
Year Of Passing
Subjects
Full Marks
Marks Obtained
% Of Marks
% Of Marks Without 4th Subject (Best Of Five)
Others
University
Institute Name
Year Of Passing
Subjects
Full Marks
Marks Obtained
% Of Marks
Declaration Of Student
I HEREBY DECLARE THAT THE PARTICULAR GIVEN ABOVE ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF