Dr. D. Y.

Patil Vidyapeeth, Pune

Accredited (3rd Cycle) by NAAC with a CGPA of 3.64 on four point scale at ‘A++’ Grade
Dr. D. Y. Patil School of Allied Health Sciences
Sant Tukaram Nagar, Dr. D. Y. Patil Vidyapeeth, Pune
Pimpri, Pune - 411 018, Maharashtra (India) (Deemed to be University)

Provisional Admission Form 2024-25

From Name M.Sc. Clinical Embryology Programme - April 2024

*00010*
Form No. 00010 Date 01/02/2024

Program Name M.Sc. Clinical Embryology

Name Madhura Kanchan

Email ID madhu32002@gmail.com

PERSONAL DETAILS
Mobile No. 9011796727 Alt. Mobile No.

Date Of Birth 03/07/2002 Gender Female

Religion Hindu Caste Hindu-Maratha

Category Open Aadhaar No. 669754961398

PAN No. KSWPK0707A Passport No.

Guardian Name Nationality Indian

Mother Tongue Marathi Marital Status Unmarried

ADDRESS
Current Address Permanent Address

2/6 , Sambhaji Housing Society , Senapati Bapat 2/6 , Sambhaji Housing Society , Senapati Bapat
Road , Pune -411016 Road , Pune -411016

Pune, Maharashtra Pune, Maharashtra

India, 411016 India, 411016

EDUCATIONAL DETAILS
Sr Marks
Course Name Name of Institute Board Year Special Subjects
No. (%)
Savitribai
A+
B.Sc Sir Parashurambhau College Phule
1 2023 /CGPA : Microbiology
Microbiology Pune University
8.67
Pune

DOCUMENTS
Sr
Document Name
No.
1 10th Marksheet

1/2
2 12th Marksheet

3 Graduation Marksheet

DECLARATION
1. I hereby declare that the above information is true and the best of knowledge.
I am aware that if any information herein is found to be incorrect or incomplete,
my application form will be rejected/admission will be cancelled.
2. If admitted to Dr. D. Y. Patil Vidyapeeth, Pune, I shall abide by its rules and
regulations.
3. I have read and understood all the provisions contained in the brochure and
hereby agree to abide by these provisions.
4. Entrance test application form fees is non-refundable.
Candidate Signature

2/2