KEONJHAR INSTITUTE OF MEDICAL SCIENCE & RESEARCH, KEONJHAR (KIMSR) (PHARMACY COLLEGE)
D.PHARM Admission / Registration Form
Name
First Name
Middle Name
Last Name
Father's Name
Mother's Name
Date of Birth
-
Month
-
Day
Year
Date
Aadhaar No.
Religion
Caste
SC
ST
OBC
General
Educational Details
Rows
Marks Secured
Total marks
Percentage
10th
+2 Sc
Mobile No
Please enter two valid phone number.
Format: (91) 0000000000 / 0000000000.
Address
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