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  • Pharmacist Detail Form

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    ravi sheladiya
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    The document contains a registration form where the applicant needs to provide details in capital letters only. The form requests information like name, date of birth, gender, education qualifications, address, contact details and other personal details for registration, fresh admission, transfer or degree addition in a pharmacy college. The applicant needs to fill capital letters for college name, registration number, education boards and other identifying information as per the instructions on the form.

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    The document contains a registration form where the applicant needs to provide details in capital letters only. The form requests information like name, date of birth, gender, education qualifications, address, contact details and other personal details for registration, fresh admission, transfer or degree addition in a pharmacy college. The applicant needs to fill capital letters for college name, registration number, education boards and other identifying information as per the instructions on the form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    5 views1 page

    Pharmacist Detail Form

    Uploaded by

    ravi sheladiya
    The document contains a registration form where the applicant needs to provide details in capital letters only. The form requests information like name, date of birth, gender, education qualifications, address, contact details and other personal details for registration, fresh admission, transfer or degree addition in a pharmacy college. The applicant needs to fill capital letters for college name, registration number, education boards and other identifying information as per the instructions on the form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Fill up all the details in the capital letters only 

     
    [   ] Fresh Registration       [   ] Transfer       [   ] Degree Add. 
     
    College State     : _________________________________________________ ____________ 
    College Name     : _________________________________________________ ____________ 
    Qualification     : [  ] D.Pharm  [  ] B.Pharm  [  ] Pharm D / Pharm D (PB)        [  ] M.Pharm 
    Final Year Seat No.  :_________________________________________________ ____________ 
    College Joining Date   : ____ / _____ / ________   Passed Date : _____ / ______ / _______ 
    Name       : ______________   _____________________   ______________ 
    (Surname)     (First Name)       (Last Name) 
    Birth Date     : _____ / _____ / ________   Birth Place : ___________________ 
    Gender      : [  ]  Male    [  ]  Female  Nationality : ___________________ 
    Blood Group     : _______________     Religion : ___________________ 
    Category     : _________________________ (SC / ST / OBC/SEBC / General) 
    SSC Passed Year   : ________/ _________(mm/yyyy) 
    SSC School Name   : __________________________________________________________ 
    SSC Board     : __________________________________________________________ 
    HSC Passed Year   : ________/ _________(mm/yyyy) 
    HSC School Name   : __________________________________________________________ 
    HSC Board     : __________________________________________________________ 
    Locality     : [  ]  Urban  [   ]  Rural 
    Resi. Address     : _____________________________________________________________ 
    ______________________________________________________________ 
    City: ________________ State: ______________ Pincode: ______________ 
    Phone No.    : ____________________   Mobile No. : _________________________ 
    E‐mail ID     : _____________________________________________________________ 
    Aadhar Card No   : _____________________________________________________________ 
     
     
     
     

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