MRDCW Admission Form

NEET DETAILS

Hall Ticket

Score

Percentile

Rank

Name as per Intermediate(10+2)

Date of Birth(DD/MM/YY)

Domicile State (or) U.T

Gender

Nationality

Caste/Category

Father's Name

Father Mobile No

Mother's Name

Mother Mobile No

Total Annual Parental Income

Address(Permanent)

City

Pincode

Local Guardian Name(If Any)

Guardian Mobile No

Admission Category

Age

Place of Birth

Mother Tongue

Religion

Blood Group

Father's Occupation

Father Email ID

Mother's Occupation

Mother Email ID

Student Mobile No

Corresponding Address

City

Pincode

Guardian Email

Student Email

Passport/Visa/Aadhar

Aadhar No.

Passport No.

Valid Till(Date)

Parent Pan No.

Issued By

Passport Issued By

Visa Status

Student Pan No.

Contact Details in an Emergency

Name

Phone No.

Identification Marks 1.

Relationship

Email Id.

Identification Marks 2.

ACADEMIC DETAILS

SSC/Equivalent

Name of School/Place

Year of Passing

Board/Place

Marks Obtained

Max. Marks

Percentage

Grade

ACADEMIC DETAILS

Inter (10+2)/Equivalent

Name of College/Place

Year of Passing

University/Place

Marks Obtained

Max. Marks

Percentage

Grade

Marks obtained in Group subjects at 10+2 level, Total two years marks with practicals.

Course

Physics

Chemistry

Biology

Total

English Marks

Marks Obt

Max. Marks

Percentage

MISCELLANEOUS INFORMATION

Extra Curricular / Sports Activities

Games / Sports and Level of Participation (School/College State/National/International)

Details of Extra Curricular Activities (if any)

Registration Date

Upload Photo

Kindly check each field of the application before submitting.Once submitted form will not be edited.

Declaration by the Candidate:

I declare that the information given above is true to the best of my knowledge. My admission is liable to be cancelled if any of the above information is false. I also undertake to abide by the rules and regulations as laid down by Malla Reddy Dental College for Women, (A Constituent unit of Malla Reddy Vishwavidyapeeth (Deemed to be University)).

APPLICATION FOR ADMISSION INTO BDS COURSE ACADEMIC YEAR 2024-2025