Name of Student(According to 12th Mark sheet)*
Father’s Name:*
Gender: MaleFemale
Date of Birth:
Residential Address:*
Mobile Number: 1*
Mobile Number: 2
Email id:
University:* Vinnytsia National Medical University : Ukraine (6 Year)West Kazakhstan Marat Ospanov State Medical University : Kazakhstan (5 Year)Alfarabi Kazakh National University : Kazakhstan (5 Year)Asian Medical Institute : Kyrgyzstan (5 Year)Other
Course:* MBBSMDMSPreparatory Course
10th Marksheet
12th Marksheet
Neet Score Card
Passport size photo (latest & any background)
Passport first Page (if available)
Passport last page (if available)
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Name*
Contact Number*
Your City*
