PERSONAL DETAILS [ व्यक्तिगत विवरण ]

New Applicant
Selected Group:
P-डिप्लोमा इन फार्मेसी
Applicant Name:*
[ Please do not use any prefix such as Mr. or Ms. etc ]
Father's Name:*
[ Do not use any prefix such as Shri or Dr. Etc.]
Mother Name:*
[ Do not use any prefix such as Smt Etc. ]
If Appearing For Pharmacy(Group-P), Select Subject:*
Date of Birth:*
Gender:*
Nationality:*
Are you a Bonafide Resident of Uttarakhand ?:*
Category:*
[ Category will not be changed after registration. ]
Sub Category:*
For Claiming Reservation Facility For Cerificate Holder in N.C.C, N.C.C CERTIFICATE PASSED:*
Mobile Number:*
[ 10 Digit Mobile Number ]
Qualifying Examination:*
➤View Qualification Details.
Qualifying Examination Appeared/Passed:*
Year Of Passing Qualifying Examination:*
Examination center City Name-1:*
Examination center City Name-2:*
Aadhar Number:

ADDRESS DETAILS [ पते का विवरण ]
CORRESPONDENCE ADDRESS [ पत्राचार का पता ]
Address :*
[ Don't Enter Your Name In The Address Field's ]
State:*
District :*
Pin Code:*
PERMANENT ADDRESS [ स्थाई पता ]
Address :*
[ Don't Enter Your Name In The Address Field's ]
State:*
District :*
Pin Code:*
E-Mail Address:* / Confirm E-Mail Address:*
Password:* / Confirm Password:*(8 to 12 character)
   Not Allowed In Password ➤ Space,",',~,`,Comma,=