Admission For D. Pharm and B. Pharm

Excellence in Pharmaceutical Education and Research Under Agnibina College of Pharmacy

Basic Info

First Name *

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Last Name *

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Father Name *

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Father Occupation

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Phone *

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Email *

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Gender *

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Date Of Birth *

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Religion

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Caste

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Marital Status

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Blood Group

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Aadhar Card No.

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Passport No

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Present Address

State

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District/City

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Address

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Permanent Address

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District/City

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Address

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Academic Information

Program *

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Educational Info

12th School Level Exam Information

School Name *

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Roll No *

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Passing Year *

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Passing Marks *

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Documents

Photo: Best Resolution Height- 300 PX, Width- 300 PX *

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Signature: Best Resolution Height- 100 PX, Width- 300 PX *

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