Al shifa college of paramedical sciences

Course applied for*

DMLT(diploma in medical laboratory technology)
DRT (diploma in radiological techniques)
DOTT(diploma in operation theatre technology)

Name of the Applicant*

Expansion of Initial(s)

Age and Date of Birth*

Sex*

Male : Female:

Marital Status*

Caste and Religion

Name of the Parent/Guardian/Spouse

Occupation of the Parent/Guardian/Spouse

Annual Income

Nationality

E-mail*

Mobile/Telephone*

Address for Communication*

Permanent Address*

Address of the Parent/Guardian/Spouse

Are you phisically Handicaped

Male : Female:

Do you need Hostel Accommodation*

Male : Female:

Reg .No./Month/Year *

School/College *

Board /University *

Subject

Maximum Marks

Marks Obtained

% of Marks

Physics

Chemistry

Biology

Total

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Admission