Alumni Registration

Name

Sex

Age

Date of Birth

Marital Status

Spouse details

Nationality

Address for communication:

Permanent Address:

Mobile no/whats app no:

Mail ID

Year of admisssion/Batch:

Area of Specialization/additional Qualification:

Appeared in (NEET/AIIMS/JIPMER/PGI/UPSC/State Govt. Exams/ CIVIL service/ DEFENCE/ TOEFL/PLAB/USMLE) Entrance test:

Qualified in (NEET/AIIMS/JIPMER/PGI/UPSC/State Govt. Exams/ CIVIL service/ DEFENCE/ TOEFL/PLAB/USMLE) Entrance test:

Current Employment details

attach proof of employment(Xerox of ID proof/appointment order copy) Maximum 5MB

Special Achievements/Awards:

Achievements in sports/Culturals:( State/Zonal/National/International):

Any other details:

Your suggestion if any:

In what way you can contribute to the development of the Institute:

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