Online Registration for PG(MD/MS) Courses 2018-19
HI-TECH MEDICAL COLLEGE & HOSPITAL, BHUBANESWAR
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CANDIDATES DESIROUS OF APPLYING TO MORE THAN ONE SUBJECT SHALL FILL UP DIFFERENT APPLICATIONS.
 
PERSONAL DETAILS
Full Name of the Applicant :
Name of Father :
Photo :
File type must be gif / jpeg. File size should be between 40kb to 50kb.
Date of Birth :  
Gender : Male FeMale
Category :
     
COMMUNICATION DETAILS
Mailing Address Permanent : Maximum 200 characters
Mailing Address Correspondence : Maximum 200 characters
State :
PIN :
Mobile Number :
Phone Number :
Email ID :
     
     
SELECT SUBJECT

Select Subject
 
ACCADEMIC DETAILS
Registered with MCI or State Medical Council  :
Class Xth Roll No.  :
Class Xth Board Name  :
     
Name of the Examination Name of the Institute/Board Year of Passing MBBS Reg. No. % of Mark
MBBS

Name of the Examination 1st MBBS 2nd MBBS 3rd MBBS
Percentage

Declaration by the candidate :
I hereby declare that, the particulars stated in this application are true to the best of my knowledge and belief.