Course Type * :      Salyathantra     Kayachikitsa

Full Name *

Date of birth *

Nationality *

Marital Status *

Religion *

Community *

Name of Parent or Guardian *

Occupation *

Annual Income *

Address For Correspondence *

Address Line 1 *

Address Line 2 *

Phone *

Address of Local Guardian *

Address Line 1 *

Address Line 2 *

Phone *

Permanent Address *

Address Line 1 *

Address Line 2 *

Phone *

AIAPGET Roll No: *

AIAPGET Rank *

Year *

KEAM Rank *

Academic Qualification *

Name of the exam : *

Line 1 *

Year of Passing *

University / Board / Institution : *

Line 1 *

Roll No: *

Percentage of Marks Obtained *

TCMC Reg. No: *

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Signature of student

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Internship Completion Certificate *

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TCMC Registration *

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AIAPGET Mark Sheet *

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KEAM Data Sheet

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Degree Certificate *

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Mark Sheet Image 1 *

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Mark Sheet Image 2 *

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Mark Sheet Image 3 *

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