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Admission Open For 2025-26
Form No : DPHAR2
Academic Details
School Name
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Class
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First Year
Final Year
Section
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Nationality
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Indian
Other
Admission Date
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Category
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CAP-OPEN
CAP-OBC
CAP-SBC
CAP-SC
CAP-ST
CAP-VJNT
CAP-EWS
CAP-TFWS
ACAP
IL
PROVISIONAL
Social Category
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Open
SC
ST
DA/VJ
NT-B
NT-C
NT-D
OBC
SBC
SEBC
EWS
TFWS
Admission Type
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IL
ACAP
Provisional
Student Details
First Name
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Middle Name
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Last Name
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Student Mobile No
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Student Email
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Birthday
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Age
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Gender
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Male
Female
Blood Group
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A+
A-
B+
B-
O+
O-
AB+
AB-
Mother Tongue
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Religion
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Caste
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Address Details
Present Address
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City / Tal
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District
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State
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Pin Code
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Permanent Address
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/
Same as Present
City / Tal
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District
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State
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Pin Code
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Other Details
Aadhar No
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Application Id
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Birth Place
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Birth Taluka
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Birth District
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Govt Fee Eligible
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Yes
No
Hostel Accomodation
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YES
NO
Student Photo
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Student signature
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Previous School Details
School / College Name
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Qualification
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SSC Board Name
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SSC School / Institiute Name
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SSC Passing Year
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SSC Percentage
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HSC Board Name
HSC School / Institiute Name
HSC Passing Year
HSC Percentage
Diploma Board Name
Diploma School / Institiute Name
Diploma Passing Year
Diploma Percentage
Degree Board Name
Degree School / Institiute Name
Degree Passing Year
Degree Percentage
GPAT [Seat No.]
GPAT [PCM/PCB/Score]
GPAT [PCM/PCB/%]
GPAT[Other]
MHT-MPH-CET [Seat No]
MHT-MPH-CET [PCM/PCB/Score]
MHT-MPH-CET [Other]
MHT-MPH-CET [PCM/PCB/%]
MHT-CET [Seat No]
MHT-CET [PCM/PCB/Score]
MHT-CET [PCM/PCB/%]
MHT-CET [Other]
Guardian Details
Guardian Name
*
Relation
*
Father Name
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Mother Name
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Occupation
Income
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Education
Guardian Email
Guardian Mobile No
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Guardian Address
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Guardian Photo
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