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MDMSMCH - Aiimsexams.ac - in RegistrationSlip Index Id 8nZA n6eME3aDWdIGpv4YQ

The document is a registration form for the Institute of National Importance Combined Entrance Test (INI-CET) for admission to various postgraduate medical courses. It contains personal information about the candidate, Ruban Richard P, including his registration ID, date of birth, contact details, and declaration of the accuracy of the information provided. The form also includes identification marks and a valid photo identity requirement for the examination center.

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Ruban Richard P 97
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65 views1 page

MDMSMCH - Aiimsexams.ac - in RegistrationSlip Index Id 8nZA n6eME3aDWdIGpv4YQ

The document is a registration form for the Institute of National Importance Combined Entrance Test (INI-CET) for admission to various postgraduate medical courses. It contains personal information about the candidate, Ruban Richard P, including his registration ID, date of birth, contact details, and declaration of the accuracy of the information provided. The form also includes identification marks and a valid photo identity requirement for the examination center.

Uploaded by

Ruban Richard P 97
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 - 110029

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)/MD(Hospital Administration/MDS)]

Candidate Profile Registration ID: P6421883420 Registration Date: 25/03/2024

Candidate Name: RUBAN RICHARD P

Date of Birth: 10 Oct 1999 Category: OBC (NCL)

Gender: Male Marital Status: Unmarried

Father's Name: PHILOMIN RAJ S Mother's Name: JACQULINE GRACY I

PWD Status(Person with Disability): No PWD/PwBD Category: NA

Nationality: INDIAN

Identification Mark(1): A black mole over right thigh Identification Mark(2):


A black mole over right wrist

Contact Details

Address for Permanent: Correspondence Address:


NO. 5, VOC STREET, ARIYAMANGALAM, Ariyamangalam , NO. 5, VOC STREET, ARIYAMANGALAM, Ariyamangalam , Tiruchirappalli,
Tiruchirappalli, TAMIL NADU, India, 620010 TAMIL NADU, India, 620010

Mobile No: 1. 7904049065 , 2. Alternate-MobileNo 9894570928 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: 377367288849 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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