Registration No.
Date.
Select Choice of Subject
Name
Father's Name
Mother's Name
Address for Correspondence
Mobile No
Email
Date of Birth (DD/MM/YYYY)
Gender
Male
Female
TG
Marital Status
Single
Married
Divorced
Widow
Religion
Caste
Nationality
Whether Belongs to Reserved Category
Yes
No
Category
Date of Completion of M.D.(Hom.) (DD/MM/YYYY)
Details of Medical Registration
Medical Registration No.
Date. (DD/MM/YYYY)
Name of Authority Granting Registration
Qualification : (Chronologically, record highest qualification at the top)
Teaching Experience (if any): (Chronologically, record most recent one at the top)
Research Experience (if any): (Chronologically, record most recent one at the top) [Use separate sheet if necessary]
Publication:
(only Original full research paper- Title, names of authors, name of Journal, Vol. & issue nos. and Year, record most recent publication at the top.[Use separate Sheet if necessary])
Academic Honours:
(Briefly describe any merit award/scholarship you have won)
Extra Curricular Activity:
(Briefly Describe Extra Curricular Personal and Voluntary activities you have pursued)
Preference:
(Which of the following activity would you like to part of(Choose any two))
Why do you wish to join Homoeopathy University?
Upload Your Recent Photograph(Please Upload .jpg Image(5MB)
Upload Your Signature(Please Upload .jpg Image(5MB)
Upload Your Documents(Please Upload Zip Files(5MB))
Document Attached: (Please tick)
