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    Admission For General / NM Category Seat For The Year 2013-14

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    Bhawani Singh Ralawata
    The document is an application form for admission to the MBBS program at SDM College of Medical Science's & Hospital, Dharwad for the year 2013-14. It contains information such as the applicant's name, date of birth, address, contact details, parent's occupation, rank and percentage obtained in qualifying exams, and a declaration of truthfulness signed by the applicant.

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    Admission For General / NM Category Seat For The Year 2013-14

    Uploaded by

    Bhawani Singh Ralawata
    14 views2 pages
    The document is an application form for admission to the MBBS program at SDM College of Medical Science's & Hospital, Dharwad for the year 2013-14. It contains information such as the applicant's name, date of birth, address, contact details, parent's occupation, rank and percentage obtained in qualifying exams, and a declaration of truthfulness signed by the applicant.

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    1302132215_MBBS 2013-14 file

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    The document is an application form for admission to the MBBS program at SDM College of Medical Science's & Hospital, Dharwad for the year 2013-14. It contains information such as the applicant's name, date of birth, address, contact details, parent's occupation, rank and percentage obtained in qualifying exams, and a declaration of truthfulness signed by the applicant.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as RTF, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as rtf, pdf, or txt
    14 views2 pages

    Admission For General / NM Category Seat For The Year 2013-14

    Uploaded by

    Bhawani Singh Ralawata
    The document is an application form for admission to the MBBS program at SDM College of Medical Science's & Hospital, Dharwad for the year 2013-14. It contains information such as the applicant's name, date of birth, address, contact details, parent's occupation, rank and percentage obtained in qualifying exams, and a declaration of truthfulness signed by the applicant.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as RTF, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as rtf, pdf, or txt
    of 2

    SRI DHARMASTHALA MANJUNATHESHWARA EDUCATIONAL SOCIETY , UJIRE / DHARWAD.

    SDM College of Medical Science's & Hospital, Dharwad APPLICATION FOR MBBS

    Admission for General / NM Category seat for the year 2013-14


    1.

    Name of the candidate : ABHISHEK SINGH SHAKTAWAT Date of Birth : 18/11/1994

    2.

    3. Name and address of the parents / guardian : B-45,46 ALOD PALACE ASHOK VIHAR COLONY NEAR RELIANCE PUMP KOTA ROAD JAHALAWAR RAJASTHAN ,326001

    4.

    Land Line No. (with STD Code) : 07432-230557 Mobile No. : 9414193594 Email Address : abhishekshaktawat065@gmail.com Occupation of the parent : MY FATHER IS A BUSINESS MAN If applying under NRI Who is NRI with relation Whether appeared for NEET /COMEDK / KCET / KRLM Rank No. if any: NEET AND COMEDK % of marks obtained in PUC/12th Std PCB Aggregate : 60.66 % The University / Board from which PUC/12th passed : CBSE BOARD Whether belongs to SC / ST / OBC / Minority if so Category (for Students of Karnataka only) Any other information such as extra-curricular activities

    5. 6. 7.
    8.

    9.

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    11.

    12.

    13.

    I hereby declare that, the information provided above are true and correct to the best of my knowledge and belief.

    Date: 14/02/2013 For Office use:

    Signature of the candidate

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