Full Name:

Father/Guardian's Name:

Father/Guardian's Occupation:

Father/Guardian's Annual Income: Rs. / Year

Sex: MaleFemale

Date of Birth:

Marital Status:

Nationality:

Passport Status: If Ready, PP No.

If not, Application No:

Present Address:

Pin Code:

Mobile:

Email:

Total Marks in 10+2:

% Marks in 10+2:

% Marks in PCB:

% Marks in English:

Applied for NEET 2020?:

Yes/No Qualified in NEET 2020?:

NEET Percentile Score:

Country PreferenceCentral AmericaRussiaChinaUkrainePhilippinesKazakhstan

University PreferenceAvalon University, Central AmericaShenyang Medical College, ChinaChina Medical UniversityHebei Medical University,ChinaMedical School of Nanjing University, ChinaBeihua University, ChinaNanchang University, ChinaDali University, ChinaCapital Medical University, ChinaSoochow University, ChinaBrokenshire College, PhilippinesDavao Medical School Foundation, PhilippinesGullas College of Medicine, PhilippinesNorth-Caucasian State Humanitarian Technological Academy, RussiaKazakh National Medical University, Kazakhstan

Course PreferenceMBBSMDMS

If Other: