BSMS REGISTRATION FORM : (2023-2024)
BSMS REGISTRATION FORM : (2023-2024)
Fields marked * are mandatory.
Date:
:
20-04-2024
Student Name
*
:
Email ID
*
:
Gender
*
:
Select
Male
Female
Transgender
Age
*
:
Date of Birth
*
:
Religion
*
:
Caste/Community
*
:
Nationality
*
:
Name of Father/Mother/Guardian
*
:
Occupation & Annual Income
of Father/Mother
*
:
Address for Correspondence
*
:
Mobile No
*
:
Land Line
Address for Local Guardian
:
Mobile No
:
Land Line
Permanent Address
:
Mobile No
:
Land Line
NEET Admission No
*
:
Score
*
:
Rank No
*
:
KEAM Roll No
:
Score :
Rank No :
Qualification
*
:
Name of Exam
*
:
Year of Passing
*
:
Name of the Institution
*
:
Name of the University/Board
*
:
Percentage of Marks Obtained
*
:
Physics :
% Chemistry :
% Biology :
%
Reference Name
:
Mobile No :
Reference Address
:
2024 © Santhigiri Siddha Medical College
