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APPLICATION FORM

For Admission to International MBBS Program – Batch 2018 – 19

    Personal Details :

    Guardian Occupation :

    Parent's Annual Income: Rs. / Year

    Sex : MaleFemale

    Date of Birth : Year Month Day

    Marital Status :

    Nationality :

    Passport Status : If Ready, PP No.

    If not, Application No :

    Present Address : :

    Pin Code :

    Mobile : E-mail :

    Education Qualification :

    Total Marks in 10+2 :

    % MArks in 10+2 :

    % Mrks in PCB :

    % Marks in English :

    Applied for NEET 2018?:

    Yes No Qualified in NEET 2018?:

    Yes No NEET Percentile Score :

    Country/ College/ University Preference :


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