27/03/2021 DNB-PDCET 2021

Applicant Details

Personal Details
Application Seq No Candidate's Name
22001448 SONU ANTONY
Father's Name Mother's Name
ANTONY JOSEPH GRACY ANTONY

Nationality Are you a Non Resident Indian (NRI) ?

INDIAN No

Gender Date of Birth

MALE 20/Aug/1994

Religion Category
CHRISTIAN GENERAL

Do you Belong to Economically Weaker Section (EWS) ? Are you a person with disability ?
NO NO

Contact Details
Mobile Number Alternate Mobile Number

7406636278 9764611706

Email ID
SONUANTONY94@GMAIL.COM

Identification Details
Do you have Government of India issued VOTER ID Do you have Government of India issued PAN CARD ?
CARD ?
YES
NO

Government of India Issued PAN CARD Number

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BHOPA5240G

Do you have Government of India issued DRIVING Do you have Government of India issued PASSPORT ?
LICENSE ?
NO
NO

MARK OF IDENTIFICATION 1 (Birth mark/Body mark)

RIGHT ARM MOLE

MARK OF IDENTIFICATION 2 (Birth mark/Body mark)

MOLE BEHIND RIGHT EAR

Correspondence Address
Address Line 1

1102, PLOT.55, SHANTHI HEIGHTS

Address Line 2
SECTOR-35, KAMOTHE, NAVI MUMBAI

Country State
INDIA MAHARASHTRA

City/District Pin Code

RAIGAD 410206

Is Permanent Address same as Correspondence

address?
YES

Permanent Address
Address Line 1
1102, PLOT.55, SHANTHI HEIGHTS

Address Line 2
SECTOR-35, KAMOTHE, NAVI MUMBAI

Country State
INDIA MAHARASHTRA

City/District Pin Code

RAIGAD 410206

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MBBS Details
Country of completion of MBBS Qualification
INDIA

State
KARNATAKA

City University
BANGALORE URBAN RAJIV GANDHI UNIVERSITY OF HEALTH SCIE
NCES, KARNATAKA

Name of College Month and Year of Passing

ST. JOHNS MEDICAL COLLEGE, BANGALORE 01/2017

POST GRADUATE DIPLOMA QUALIFICATION Details

State/UT of Completion
MAHARASHTRA

City of Completion University of Completion

MUMBAI CITY MAHARASHTRA UNIVERSITY OF HEALTH SCI
ENCES, NASHIK

Name of College Name of Speciality Course

SETH GS MEDICAL COLLEGE, MUMBAI PAEDIATRICS(DCH)

Additional Qualification (PG Diploma) Registration Details

Is your PG Diploma Qualification recoginzed as per Is your PG Diploma Qualification registered with a
provision of NMC Act 2019/ repealed IMC Act ? medical council (NMC/MCI/SMC) ?

Yes Yes

NMC/MCI/SMC Registration Number Medical Council

2021020810 MAHARASHTRA MEDICAL COUNCIL

Month and year of passing PG Diploma Qualification

09/2020

Additional Information
Deported/Rusticated during Medical Course Charged of use of unfair means by NBE/Other
examination body
No

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No

Test Center Details

State City

MAHARASHTRA MUMBAI

Payment Details
Amount Payment Mode
5900 online

Payment Transaction No Payment Status

5547851949937 Successful

Candidate Images Upload Details

Captured Photo

Uploaded Photo

Signature

Left Thumb Impression

Attachments
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Upload proof of passing PG Medical Diploma QualificationClick here.

Upload proof of recognition of PG Diploma Qualification as per provisions of NMC Act 2019/
repealed IMC Act (Additional Qualification Registration Certificate issued by SMC/MCI, IMR
Certificate, self attested copy of printout of MCI website confirming to recognition status)Click here.

Declaration

DNB PDCET is a proprietary examination and is conducted by the National Board of Examinations.
The contents of this exam are confidential, proprietary and are owned by the National Board of
Examinations. NBE explicitly prohibits the candidate from publishing, reproducing or transmitting
any or some contents of this exam, in whole or in part, in any form or by any means verbal or
written, electronic or mechanical or for any purpose whatsoever. NBE shall not entertain any
request for sharing any content of the examination including Answer Keys/Answer Sheets.

No content of this exam must be shared with friends, acquaintances or third parties including
sharing through online means or via social media. Social media includes but not limited to SMS,
Whatsapp, Facebook, Twitter, Hangouts, Blogs etc using either one’s own account or proxy
account(s).

By registering for and /or appearing in DNB PDCET the candidate explicitly agrees to the above
Non Disclosure Agreement and general terms of use for DNB PDCET as contained in this
Information Bulletin, and DNB PDCET website.
I certify that I have physically attended the course of my primary medical qualification for the
mandated period as per requirement of the University concerned toward award of my primary
medical qualification degree certificate.

Violation of any act or breach of the same shall be liable for penal action and cancellation of the
candidature at the bare threshold.

I certify that I fulfill the eligibility requirements for DNB PDCET and have furnished complete and
correct information. I understand that any instances of furnishing incorrect information detected
during any stage of the examination process will automatically disqualify me from the examination
process and I will not be allowed appear for DNB PDCET in future.

Similarly, if such instances go undetected during the current examination process but, are
detected in subsequent years, such disqualification will take place with retrospective effect.

I also understand that providing incomplete information will automatically disqualify me from the
examination process.I have read the information bulletin and do hereby undertake that I will not
indulge in any unfair means/practice for NEET-PG I understand that the decision of NBE shall be
final and binding upon me.

Any dispute concerning DNB PDCET would be subject to Jurisdiction of the Competent Courts
exclusively at Delhi/New Delhi only. I will comply with the Non Disclosure Agreement as indicated in
the information bulletin. I certify that I have read the information bulletin thoroughly."

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