* Fields are Mandatory

Session *
---2019-20

Course *
BDS

NEET Roll Number *

Ranking *

Percentile *

Name of Candidate *

Mobile Number *

Email *

Passport/Aadhaar Number *

Date of Birth *

Father‘s Name *

Father‘s Occupation

Father's Mobile Number

Father's Email

Mother's Name

Mother's Occupation

Mother's Mobile Number

Gender *
MALEFEMALE

Are You Applying for Hostel *
---YESNO

Caste Category *
---GENERALOBCSCSTSBCOTHER

Region *
---RAJASTHANOUTSIDE OF RAJASTHAN

Nationality *

Father's Annual Income

Guardian's Name

Guardian's Occupation

Upload Photograph*

Upload 10th Marksheet *

Upload 12th Marksheet *

Upload Candidate Signature *

Upload Gap Certificate

Upload Other Certificate

Upload Caste Certificate

Upload NEET Marksheet *

Upload Parents/Guardian's Signature *