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  • D.D.Medical College & D.D.Hospital: Multi, Super & Higher Speciality

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    Atif Imam
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    This document contains an online application form for the MBBS course at D.D.Medical College & D.D.Hospital for the years 2011-2012 and 2014-2015. The application requests basic information about the applicant such as name, date of birth, address, parents' names and occupations, nationality, email, contact phone number, community, and marks obtained in Physics, Chemistry, and Biology in Classes 11 and 12. It notes that the non-refundable application fee is Rs. 25,000 and requires a signature declaring the applicant's willingness to apply and acknowledgement that the fee will not be refunded if absent from the exam.

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    Online Application

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    This document contains an online application form for the MBBS course at D.D.Medical College & D.D.Hospital for the years 2011-2012 and 2014-2015. The application requests basic information about the applicant such as name, date of birth, address, parents' names and occupations, nationality, email, contact phone number, community, and marks obtained in Physics, Chemistry, and Biology in Classes 11 and 12. It notes that the non-refundable application fee is Rs. 25,000 and requires a signature declaring the applicant's willingness to apply and acknowledgement that the fee will not be refunded if absent from the exam.

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    7 views3 pages

    D.D.Medical College & D.D.Hospital: Multi, Super & Higher Speciality

    Uploaded by

    Atif Imam
    This document contains an online application form for the MBBS course at D.D.Medical College & D.D.Hospital for the years 2011-2012 and 2014-2015. The application requests basic information about the applicant such as name, date of birth, address, parents' names and occupations, nationality, email, contact phone number, community, and marks obtained in Physics, Chemistry, and Biology in Classes 11 and 12. It notes that the non-refundable application fee is Rs. 25,000 and requires a signature declaring the applicant's willingness to apply and acknowledgement that the fee will not be refunded if absent from the exam.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 3

    D.D.MEDICAL COLLEGE & D.D.

    HOSPITAL
    Multi, Super & Higher Speciality
    No.61, D.D.Nagar Bus Stop, (Chennai to Tirupathi National Highways) Kunnavalam Post, Tiruvallur Tk & Dt.Chennai - 631 210 Ph: 044-27677700 upto 99(100 lines). Web: www.ddhospitals.org / Email:ddhospitals@yahoo.com ***************** ONLINE APPLICATION FORM FOR MBBS COURSE 2011-2012 2014-2015

    1.
    2. 3. 4.

    Name
    Date of Birth Sex (Male/Female) Address : : :

    5.

    Name of the Father Mother

    6.

    Occupation of Father : Mother Nationality E-mail Address : :

    7. 8. 9.

    Contact phone no with : STD Code : : Rs. 2 5 0 0 0

    10. Mobile No 11. Community

    12. Cost of Application Form : (Non Refundable) 13. Details of payment (D.D.No : with Bank name / Cash) 14. Marks obtained +1 +2 DECLARATION :

    Physics

    Chemistry

    I declare that I am willing to apply online examination for the above course and I, further declare that I have not claim the Examination Fee Rs.25000/- ( Rupees Twenty Five Thousand Only) paid by myself and I am aware that Examination fee paid will not be refunded even if I am absent to the exam at any circumstances. Place Date : :

    (DDF)

    ****************

    Space for photograph attested by Gazetted officer

    (Rupees Twenty Five Thousand Only)

    Biology

    Total Marks Obtained

    SIGNATURE OF THE CANDIDATE

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