LAST DATE FOR APPLYING IS 15th APRIL 2019

QUERY REGARDING REGISTRATION PART, PAYMENT FAILURE / PAYMENT DEDUCTED & NOT ABLE TO LOGIN WILL NOT ENTERTAIN AFTER 04:00PM(15th APRIL 2019)

KINLDLY READ INFORMATION BULLETIN CAREFULLY AND BE READY WITH FOLLOWING DETAILS AND SCANNED DOCUMENTS TO FILL ONLINE FORM.
ALL DOCUMENTS(.pdf format) AND PHOTO & SIGNATURE(.jpg format) SHOULD BE SCANNED THROUGH SCANNER, DO NOT UPLOAD THE SAME BY CLICKING WITH YOUR MOBILE/CAMERA

Candidate Name:(full name as per MBBS degree)
Father Name:( full name  as per certificate)
Mother Name: (full name as per certificate)
Date of Birth , Gender, Email, Address
1st Mobile No.(mandatory)      and 2nd Mobile No.(optional)

After filling above details be ready with you DEBIT/CREDIT CARD /NETBANKING details for exam fee payment.

(at this stage it is assumed that you have read the information bulletin for eligibility criteria, as the fee will not refund if deducted.)

SCAN copy of CANDIDATE PHOTO

SCAN copy of CANDIDATE SIGNATURE

The scanned photograph and signature to be uploaded must be in jpg/jpeg format and should not be more than 100KB size.

PHOTO EXAMPLE

SIGNATURE EXAMPLE

PHOTO EXAMPLE


MCI/SMC No.

 

Date of Registration

 

QUALIFICATION DETAILS

COURSE

SUBJECT

COLLEGE/INSTITUTE NAME & UNIVERSITY NAME

DATE OF PASSING

DATE OF JOINING

DATE OF COMPLETION

MBBS

 

Required

Required

 

 

DIPLOMA

Select as per category

Required as per your category

Required

 

 

PG DEGREE

(PASS MD/MS)

Select as per category

Required

Required

Required

Required

DM/MCh

Select as per category

Required

Required

 

 

DNB

 Select as per category

Required

 

Required

Required

REGISTRATION , TCC , THESIS & LEAVE DETAILS OF DNB CANDIDATES

Regn. No.

 

Duration of Course

 

TCC attaching with the Application

 

Thesis Status

 

Thesis Submission Date

 

Leave Taken During the Training period

 

Thesis Topic

 

THEORY EXAM CENTER CHOICE

1st Centre

 

2nd Centre

 

DETAILS OF YOUR LAST APPEARANCE IN DNB EXAM (if appeared earlier in DNB Final Exam)

Old Roll No.

 

Exam Session

 

Result

 

SCAN COPY OF FOLLOWING DOCUMENS REQUIRED TO UPLOAD AFTER FILLING THE ABOVE DETAILS

1. MBBS DEGREE(mandatory for all category of exam)
2. MCI/SMC REGISTRATION(mandatory for all category of exam)
3. DIPLOMA PASSING CERTIFICATE( if applicable to your category of exam)
4. PG DEGREE(MD/MS/DNB)-(if direct MD/MS candidate appearing  and if DM/MCh category) AND BONAFIDE CERTIFICAE   
5. DM/MCh( if applicable to your category of exam) AND BONAFIDE CERTIFICAE   
6. IMR/AQRC ISSUED BY MCI REQUIRED (In case ‘RECOGNISED” status not shown at MCI’s website.) 7. FOR DNB CANDIDATES:
DNB REGISTRATION LETTER, PROVISIONAL/FINAL TRAININ COMPLETION CERTIFICATE, THESIS SUBMISSION PROOF/THESIS ACCEPTANCE COPY