1Personal Details

Full Name *

Email *

Phone *

WhatsApp Number

Date of Birth *

Gender *

Category *

Nationality

2Address Details

Full Address *

City *

State *

Pincode *

310th Standard Details

Board *

Passing Year *

Percentage *

412th Standard Details

Board *

Stream *

Passing Year *

Percentage *

5NEET Details (Mandatory for B.P.Th)

NEET Score *

NEET Rank *

NEET Roll No *

6Work Experience (Optional)

I have relevant work experience

Note: After submitting this form, our admission team will contact you for document verification. Keep your original documents ready for verification.