Apply

Step 01 of 04

Basic Information

Email Address *

Full Name *

Date of Birth *

Nationality *

Indian Other

Gender *

Male Female Other

Are you a Person with Disability? *

Yes No

Phone Number *

State *

District *

Pincode *

Home Address *

Is Permanent Address same as Home Address? *

Yes No, enter separately

Permanent Address *

Area Type *

Rural Urban Semi-Urban Remote

Government Category *

General SC ST OBC Minority Others

Change Stream

Step 02 of 04

Family Details

Mother's Name *

Mother's Occupation *

Mother's Contact *

Mother's Education *

Illiterate Primary School Secondary School Intermediate (X Pass) XII/ +2 / Junior College Graduate or Above

Is Mother's Address Same as Self? *

Yes No, please mention Address

Mother's Address *

Father's Name *

Father's Occupation *

Father's Contact *

Father's Education *

Illiterate Primary School Secondary School Intermediate (X Pass) XII/ +2 / Junior College Graduate or Above

Is Father's Address Same as Self? *

Yes No, please mention Address

Father's Address *

Head of Family

Mother Father Grand Parent Other Relatives Other Institutions/ Individual

If Other Institution/Individual, details including Name, Address and Contact details *

Annual Family Income *

Do you live in a single parent household? *

Yes No

If yes, give details *

Are you an orphan? *

Yes No

If yes, give details *

Step 03 of 04

Educational Details

Class X / Matriculation / Secondary

Name of Institution *

Address of Institution

Institution Contact Details (Mobile/Landline)

Type of Institution

Government Private Government Funded (Partial funding) International School Others

Area where Institution is situated *

Urban Rural Semi-urban

Board of Education *

What was your X percentage/ Grade/ CGPA? *

Class XII / Intermediate / Higher Secondary

Name of Institution *

Address of Institution

Institution Contact Details (Mobile/Landline)

Type of Institution

Government Private Government Funded (Partial funding) International School Others

Area where Institution is situated *

Urban Rural Semi-urban

Board of Education *

What was your XII/ +2 percentage/ Grade/ CGPA? *

What was your NEET All India Rank? *

Undergraduate Course Details

Have you applied for admission for undergraduate course? *

If no, why? *

Which College have you applied to? *

All India Institute of Medical Sciences, Delhi Christian Medical College, Vellore Banaras Hindu University, Varanasi King George`s Medical University, Lucknow Jawaharlal Institute of Post Graduate Medical Education & Research, Puducherry Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi Aligarh Muslim University, Lucknow Maulana Azad Medical College, Delhi All India Institute of Medical Sciences, Bhubaneswar Govt. Medical College & Hospital, Chandigarh Other- Top 50 NIRF Ranked Medical College Other

Have you received admission to undergraduate course? *

Academic Year *

Is the College listed on our Website? *

Are you interested in Scientific Research? *

Why did you take up Science? *

What kind of Research interests you? *

Step 04 of 04

Upload Documents

Upload clear scans or photographs of your documents. Accepted formats: PDF, JPG, PNG — max 5 MB each.

X Std. Certificate

Click to select a file

★ Required

Browse File

X Std. Mark sheets

Click to select a file

Optional

Browse File

XII Std./10+2 Mark sheets

Click to select a file

★ Required

Browse File

XII Std./10+2 Certificate

Click to select a file

Optional

Browse File

Income Certificate

Click to select a file

Optional

Browse File

Disability Certificate

Click to select a file

Optional

Browse File

College Admission Proof

Click to select a file

Optional

Browse File

ID Proof

Click to select a file

★ Required

Browse File

MBBS Scholarship

Basic Information

Family Details

Educational Details

Class X / Matriculation / Secondary

Class XII / Intermediate / Higher Secondary

Undergraduate Course Details

Upload Documents