Application Form For Admission To Second Year
Diploma In Pharmacy Course 2020-21
Full Name of Applicant
Mother Name
Gender
Male
Female
Date Of Birth
Parents Phone Number
Applicant Phone Number
Address
Email
Aadhar Card No.
Category
OPEN
SC
ST
VJ
NT-1/2/3
SBC
OBC
Scholarship Holder in D.Pharm-I :
Yes
No
Fees Paid
Mode Of Payment
Cheque
Online Transfer
NEFT
DD
Receipt Number
Subject Wise Details of Marks:
Theory PH1
Theory PC-1
Theory PGY
Theory BCP
Theory HAP
Theory HECP
Practical PH1
Practical PC-1
Practical PGY
Practical BCP
Practical HAP
Applicant Photo:
Submit