Data Sheet No. (for Office Use )
EMBASSY OF INDIAKATHMANDU
Note : 1. Data Sheets are to be submitted in Five Copies along with required enclosures.2. Before filling this Form, read the instructions carefully. All entries should be made in Capital Letters.
(i) Choice of Examination Centre (Kathmandu or Birgunj)Please write one center only in the box
(ii) Out of the six courses given below, choose only two courses andindicate in the box. More than two course are not allowed.
COURSE – I3. B.Pharma [Scholarship] 6. B.Sc Dairy Tech. (Scholarship)COURSE – IIChoice – I Choice – II Choice - III(iii) If opting for BE, indicate preferredbranch of Engineering
1. Candidate's Name (in capital letters)
(please keep one box blank between name, middle name & sur name)
2. Father's Name (in capital letters) [ Father’s Occupation: ___________________________________________]3. Mother’s Name (in capital letters) [ Mother’s Occupation: ___________________________________________]4. Date of Birth
DAY MONTH YEAR DAY MONTH YEAR YEAR MONTH DAY
5. Correspondence Address (in capital letters in English) Signature of Candidate
Name :Father’s Name : Address ::District :6.
Please affix recentpassport sizePhotograph
Write your Permanent District
(In the box in Capital letters )1. MBBS [SFS] 4. B.VSc [Scholarship]2. BE [Scholarship] 5. B Sc Ag. [Scholarship]a. In Christian Era b. In Birkram Samwat c. Age as on 1 July, 2009