Online Application form for Counselling to MD/MS Course at Govt. Medical College & Hospital
Sector 32, Chandigarh(Session 2018)

Gender :
Date of Birth: Calendar
 (Enter date in dd/mm/yyyy format)
Place of Birth:
Father's Name :
Mother's Name :
Nationality :
Category :
Marks obtained in NEET PG 2018 :
NEET PG 2018 National Rank(General) :
NEET PG 2018 National Rank(SC) :
Correspondence Address:
Permanent Address:
Residential Telephone with STD Code:
Email Id:
Are You Employed if Yes, give the following details :
Name of Institute:
Govt/Semi Govt/Pvt:
Date of Joining: Calendar
Detail of MBBS :
Examination Passed Institution Attempts at Which Passed Year/ Session Maximum Marks Marks obtained
Details of compulsory Rotatory internship:
Date of Completion:-> Calendar    
*Note : First select Name of Hospital, Period From and Period To then press Add to incorporate these selected values into Database.with this facility user can enter multiple experiences through this single form.
Name of Hospital Period From Period To
Details of compulsory Rotatory internship entered by You:-
Name of HospitalPeriod FromPeriod To
Application Fee :
challan Amount:
Upload Photo(jpg,png,gif only):
* Image size must be less than 15 kb