Online Application

Course Applying for:

Diploma in ECG/Non Invasive Cardiology Lab Technician Diploma in X-ray/Radiographer Diploma in O.T. Technician/Assistant Diploma in Medical Lab. Tech. Certificate in Dresser Diploma in Anaesthesia Tech. Diploma in Ophthalmic Assistant

Name of the Candidate:

Gender:

Male Female Other

Date of Birth:

Fathers Name:

Occupation:

Designation:

Annual Income:

Mother's Name:

Qualification

10th 12th Graduate Post Graduate Other

Annual Income(In Lakh):

Address

Pin Code

Image

Signature:

Submit