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CANDIDATE INFORMATION SHEET Name Name of College

Educational Background: (In reverse chronological order starting from the latest up to SSC) QUALIFICATION (Degree/ Diploma) B. Pharma/ D.Pharma XII X Extra-curricular Activities/ Achievements: 1 BOARD/ UNIVERSITY INSTITUTE YEAR OF PASSING % MARKS /CGPA

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Personal Information Date of Birth Contact No. Permanent Address E mail Id Location Preferences (if any) I hereby affirm that the information furnished in this form is true and correct. Date:

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