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Ugcourses - Aiimsexams.ac - in RegistrationSlip Id 0KNblQ0oBpkK0hOvjB59c0quALHJIO9gZFyiMv+6UVe11oM4 hn0

The document is an undergraduate basic registration form for AIIMS containing information such as the candidate's name, date of birth, gender, parents' names, address, contact details, photo identity details, and an undertaking signed by the candidate.

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10b2ujjalhazarika2021
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83 views1 page

Ugcourses - Aiimsexams.ac - in RegistrationSlip Id 0KNblQ0oBpkK0hOvjB59c0quALHJIO9gZFyiMv+6UVe11oM4 hn0

The document is an undergraduate basic registration form for AIIMS containing information such as the candidate's name, date of birth, gender, parents' names, address, contact details, photo identity details, and an undertaking signed by the candidate.

Uploaded by

10b2ujjalhazarika2021
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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All India Institute of Medical Sciences

Ansari Nagar, New Delhi - 110608


AIIMS Undergraduate Basic Registration Form

Candidate Profile Registration ID: U5332428631 Basic Registration Date: 02/04/2024

Candidate Name: NANDINI BAYAN Date of Birth: 08 Oct 2005

Gender: Female Category: General

Father's Name: TARUN BAYAN Mother's Name: BINITA BAYAN

PWBD Status: No PWBD Category: NA

Nationality: INDIAN State of Domicile: ASSAM

Contact Details

Address for Permanent: Correspondence Address:


PANDU SADILAPUR, NEAR GAMMON INDIA, Pandu , Kamrup, PANDU SADILAPUR, NEAR GAMMON INDIA, Pandu , Kamrup, ASSAM,
ASSAM, India, 781012 India, 781012

Mobile No: 1. 7086262851 , 2. Alternate-MobileNo 9365958226 E-Mail ID: [email protected]

Valid Photo Identity (To be presented in original at the Examination Center along with Admit Card)

ID Proof: Aadhar Card ID No: 361787015656 Place of Issue: India Issue Date: NA Valid Till: NA

UNDERTAKING/DECLARATION: I hereby declare that the information furnished by me in the Registration/Application Form is correct and nothing has been
concealed. In case any information furnished by me is found to be false/incorrect/untrue than i shall be liable to civil/criminal prosecution and my claim to
admission/appointment/registration/ service in the Institute may be cancelled/terminated.

Signature of Candidate
Thumb of Candidate

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