Registration Form

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Student Type/Account Detail

Username *

Password *

General Detail

Surname *

Name *

Mobile *

WhatsApp Number *

Email Id *

Date of Birth *

Sex *

Marital Status *

Nationality *

Father's Name *

Father Mobile Number *

Student Passport Photo * [dimensions 180*200px]

Passport Detail

Passport Number

Passport Issued at

Date of Issue

Date of Expiry

Address in India

Address Line 1 *

Address Line 2 *

City *

State *

Postal Code *

10+2 Examination Detail

University/Board *

Name of School *

Year of Passing *

Total Percentage of Marks *

Total Percentage in PCB *

Other Information

Any Other Information

I am giving my consent to MBBS Universities for using my all above details for communication & purpose of my living & studies at university.