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Admission Form

Name* :

Gender* : Male Female Others

DOB* :

Nationality* :

Religion :

Email ID* :

Blood Group :

Mother Tongue :

Languages Known :

Parent/Guardian Name* :

Parent/Guardian Email ID :

Mobile No* :

Temporary Address :

Permanent Address* :

Please Select the Course * : A.N.M GNM B.Sc P.B.BSc Paramedical

Name of the Institution Last Attended :

Name of Qualifying Exam* :

Month & Year of Passing* :

Name Of Board or University* :

Subjects Offered

Physics* :

Chemistry* :

Biology* :

Percentage Of Marks* :

We hereby declare that all the information provided above in the Application form is true to the best of our knowledge & belief.

Dhanarua School of Nursing & Paramedics