MD/MS Registration Form 2022

Application Form for Admission to MD/MS Special Stray Vacancy Round (2022-23)

Course Applied For*
- MD
- MS
Specialization*
Category*
Physically Handicapped?*
NEET Roll No*
Marks obtained in NEET*
All India Rank*
Applicant Full Name*
Email*
Father Name*
Mother's Name*
Permanent Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mobile No*
Tel No.*
Date of Birth*
DD slash MM slash YYYY
Gender*
- Male
- Female
Nationality*
Examination Passed (MBBS)*
Year of Passing (MBBS)*
Internship Completion Date*
DD slash MM slash YYYY
University*
Name and Address of the Institution*
MCI State Registration No.*
NEET Score Card Upload*
Accepted file types: jpg, pdf, dpcx, doc, png, Max. file size: 3 MB.