11/04/24, 1:16 PM
All India Institute of Medical Sciences
Ansari Nagar, New Delhi - 110608
Registration and Basic Candidate Information Form - Institute of National Importance Combined Entrance Test (INI-CET) for admission to PG courses [MD/MS/M.Ch.
(6years)/DM(6years)/MDS]
Candidate Profile Registration ID: P6421968440 Registration Date: 06/04/2024
Candidate Name: IFLAH JAN
Date of Birth: 08 Aug 1996 Category: General
Gender: Female Marital Status: Unmarried
Father's Name: NOOR UD DIN WANI Mother's Name: NEELOFAR JAN
PWD Status(Person with Disability): No PWD/PwBD Category: NA
Nationality: INDIAN
Identification Mark(1): Mole on left ring finger Identification Mark(2):
Mole below right eye
Contact Details
Address for Permanent: Correspondence Address:
H.NO. 116 KHALIDABAD , BAGHAT, Sanat Nagar , Srinagar, JAMMU H.NO. 116 KHALIDABAD , BAGHAT, Sanat Nagar , Srinagar, JAMMU &
& KASHMIR, India, 190005 KASHMIR, India, 190005
Mobile No: 1. 9797384217 , 2. Alternate-MobileNo 9622458181 E-Mail ID: [email protected]
Valid Photo Identity (To be presented in original at the Examination Center along with Admit Card)
ID Proof: Adhar Card ID No: 824755053385 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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