Paramedical Courses Application

Date of Birth

Gender
- Select Gender-MaleFemale

Blood Group

Religion

Nationality

Mother Tongue

Community
OCBCMBC/DNCSC/STOTHERS

Present Address for Correspondence with Phone Nos.

District

Pin Code

Land Line

Mobile No

Permanent Address with Phone Nos.

District

Pin Code

Land Line

Mobile No

Native Place

State

E-mail Address

Whether physically challenged person (Please mention)

Reason for choosing this course

Father

Mother

Payment Details

Please make the payment and enter the valid payment reference No

Payment Mode -Select-GpayNEFTIMPSUPI

Payment Reference No

Payment Date

Amount Paid

Upload Reference Document (Pdf file only)

Details of Educational Qualification including Additional Qualifications, if any. (Proof to be attached)

Upload Transfer Certificate (PDF file only)

Upload Hsc Mark Sheet (PDF file only)

Upload Community Certificate (PDF file only)

Upload Eligibility Certificate (PDF file only)

Upload Migration Certificate (PDF file only)

Upload Passport Size Photo (JPG file only)