FACULTY OF DENTISTRY
REGISTRATION FORM FOR INSTITUTIONAL STARY VACANCY
B.D.S. COURSE 2021-22
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General
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Sharad Pawar Dental College & Hospital, Sawangi (Meghe), Wardha
PERSONAL INFORMATION
Name of the Candidate
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(as it appears in S.S.C. Board Certificate)
Fathers Name
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Mobile No.
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Email
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Date of Birth
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Gender
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Select Gender
Male
Female
Religion
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Nationality
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Aadhar Card No.
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Caste & Sub Caste
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Address for Correspondence
Address (House no. street/ area etc.)
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Village/Tehsil
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City
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District
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State
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PIN Code
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Previous Academic Record
Name of Previous School/College
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H.S.S.C./XIIth marks as per Mark Sheet
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English
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Physics (P)
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Chemistry (C)
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Biology (B)
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Total PCB Marks
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PCB Percentage
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NEET-Year & Month of Passing
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NEET-2021 Roll No.
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NEET-2021 Marks Obtained
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NEET-2021 All India Rank
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(Overall Rank )
For Office Use only
Verified that he/ she is eligible for admission to ................................................................. for the academic session 2021-22.
Dean
Authorized Signatory