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Basic Reg Aiims

This document is a basic registration form for postgraduate medical courses at AIIMS in New Delhi. It contains information about a candidate named Vetrivel, including his personal details, contact information, photo ID details, and an undertaking he signed declaring the information provided is true.

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Vetrivel Tamizh
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100 views1 page

Basic Reg Aiims

This document is a basic registration form for postgraduate medical courses at AIIMS in New Delhi. It contains information about a candidate named Vetrivel, including his personal details, contact information, photo ID details, and an undertaking he signed declaring the information provided is true.

Uploaded by

Vetrivel Tamizh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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All India Institute of Medical Sciences

Ansari Nagar, New Delhi - 110608


 
Basic Registration Form - AIIMS PG Courses[MD/MS/MCh(6YRS)/DM(6YRS)/MDS]

Candidate Profile Registration ID: P6131167494 Registration Date: 30/12/2018

Candidate Name: VETRIVEL Applied Course:


MD/MS/MCH(6YRS)/DM(6YRS)

Date of Birth: 06 Apr 1996 Category: SC

Gender: Male Marital Status: Unmarried

Father's Name: GOPALAKRISHNAN Mother's Name: LAKSHMI

PWBD Status: No Mentioned Specified Disability: NA

Nationality: INDIAN

Identification Mark(1): A black mole on Left forearm Identification Mark(2):


A black mole on Right forearm

Contact Details

Mobile No: 1. 9677980896 ,        2. Alternate-MobileNo 9443594380 E-Mail ID: [email protected]

Valid Photo Identity (To be presented in original at the Examination Center along with Admit Card)

ID Proof: Adhar Card ID No: 257108358282 Place of Issue: India Issue Date: NA Valid Till: NA

UNDERTAKING/DECLARATION: I hereby declare that the information furnished by me in the Registration/Application Form is correct and nothing has been concealed.
In case any information furnished by me is found to be false/incorrect/untrue than i shall be liable to civil/criminal prosecution and my claim to
admission/appointment/registration/ service in the Institute may be cancelled/terminated.

Signature of Candidate
Thumb of Candidate

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