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Register

Application for Admission

1. Program Applied for :


2. Details of Qualifying examination:
Examination Board Percentage Month & Year of Passing
Class X
Class XII
Graduation
Masters


3. Scheme Applied for:

Normal Half BPL BPL 1 BPL 2

4. Personal Details:

NAME


DATE OF BIRTH
AGE
GENDER

MARITAL STATUS

NATIONALITY
CAST
SC/ST OBC OEC OTHER

5. Contact Details:
CORRESPONDENCE ADDRESS :
MOBILE NUMBER
PIN CODE
EMAIL ID

6. Parent Details:
Name of Guardian(Father/Mother)
Occupation
Phone Number



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Our Bank Account Details :

Navodaya institute of medical technology,
917020053086957,
Axis Bank, Ottapalam,
IFSE Code : UTIB0002164