Email First Name * Father's Name * Nationality * Indian Non Indian Caste * General OBC SC/ST Caste Blood Group * A+ A- B+ B- O+ O- AB+ AB- Blood Group Address * State * Contact No. * Last Name * Mother's Name * Religion * Hindu Muslim Sikh Christan Others Religion Gender * Male Female D.O.B. * City * Pin Code * Parent's Contact No. * Educational Details : Class 10th Marks * Class 12th Marks * Graduation Marks * Class 10th Division * Class 12th Division * Graduation Division * Declaration : 1 . I shall obey the Rules & Regulations of the Institute and the Institute Mess. 2. I shall not take part in any subversive activities including ragging in any form in the Institute Campus or the Institute Mess or anywhere at Durgapur or outside anytime during my stay at the Institute. 3. If I involve myself in any type of subversive activities, the Institute Authority alone or in consultation with local Administration may take any type of disciplinary action as per prevailing Rules & Regulations of the College. 4. I also agree to pay College Installment / Hostel fees in time. If I fail to pay the Hostel fees / Installment for consistently two months / two Installments I shall be liable to be struck off from the College roll. 5. All the information furnished here are true to the best of my knowledge and belief. I agree with terms & condition. * Yes Course Applied * Bachelor in Hospital Management Bachelor of Occupational Therapy Bachelor of Physiotherapy Bachelor in Medical Laboratory Technology Diploma in Medical Laboratory Technology (D.M.L.T) Dresser Documents to be Submitted: 10th Mark Sheet * Birth Certificate * 12th Marksheet * Upload Image Here *