Home
Our Team
Appointment
Eye Care
Eye Bank
Career
FeedBack
Contact
Login
WELCOME
Call Us Now +91 02482- 244600
Admission Request form
FormId
Full Name of the Candidate(as per 12th marksheet)
*
Name of College
*
Address For Correspondence with pincode
*
Email ID
*
Invalid email format
Mobile No
*
Invalid mobile number format
Gender
Male
Female
Date of Birth (Date/Month/Year)
*
Birth Place
*
Nationality
*
Country
*
Domicile
*
State
*
Aadhar Card No
*
Voter Id No (If Student is registered in Voter's list of Election Commission then mention your Identity Card NO issued by Election Commission of India)
*
Constitutional Category of the Student
*
Quota
*
Details of Examination
Total Marks :
*
Percentage :
*
Month & Year of Passing :
Marks in English
*
Marks
Physics
*
Chemistry
*
Biology
*
Total Marks(PCB)
*
Willingness about organ donation after accident death for transplantation donor Card will be issued
No
Yes
Physically Handicapped
No
Yes
Do you have Caste Certificate?
No
Yes
Not Applicable
Do you have Caste Validity Certificate?
No
Yes
Not Applicable
Do You Have Non Creamy Layer Certificate?
Yes
No
Not Applicable
Name of HSC / CBSC / ICSE Board
*
Qualifications :
Examination
*
Subject /Course
*
Registration No
*
Divisonal Board
*
Month & Year of Passing
*
SGN © 2015. All Rights Reserved.