Maa Vaishno Institute of Paramedical College, Kanpur Nagar – Bundelkhand Institute Of Medical Science

ADMISSION FORM

Maa Vaishno Institute of Paramedical College, Kanpur Nagar

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COURSE

1. NAME OF CANDIDATE

First

Last

2. FATHER’S NAME & PROFESSION

3. MOTHER’S NAME & PROFESSION

4. DATE OF BIRTH (IN NUMBERS)

5. DATE OF BIRTH (IN WORDS)

6. CORRESPONDENCE ADDRESS

District

Pincode

7. PERMANENT ADDRESS WITH TELEPHONE NO.

District

Pincode

8. TELEPHONE NO. WITH CODE (IF ANY)

9. CATEGORY

10. NATIONALITY

11. RELIGION

12. EDUCATIONAL QUALIFICATION

HIGH SCHOOL (10th)

Year of Passing

Board/University

Percentage of Marks

INTERMEDIATE (12th)

Year of Passing

Board/University

Percentage of Marks

GRADUATION

Year of Passing

Board/University

Percentage of Marks

OTHER

Year of Passing

Board/University

Percentage of Marks

Bundelkhand Institute of Paramedical & Hospital

Dedicated to excellence in medical education, research, and patient care. We nurture future healthcare leaders with state-of-the-art facilities, expert faculty, and hands-on clinical training. Shaping a healthier tomorrow, today.

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Contact Info

Divoliya Petrol Pump Ke Samne, Kalpi Baipass Road, Orai(Jalaun)

biphjalaun@gmail.com

9455422006 , 6387363862 , 8299673329

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