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Ministry of Rural Development, Government Of India
New Admission Entry Form
  * Mandatory Filed
 
Student Name : *
Father/Husband Name : *
Mother Name : *
Date of Birth : *
Village / Town : *

District : *

Block : *

Permanent Address : *
Contact Address :
Gender :
  Male   Female
Category :
  GEN   SC   ST   OBC  OTHER
Contact No. : Mobile*
 Residence
BPL No : *
Annual Income : *
 Upload PhotoGraph :
Qualification Detail:
Course NameBoard / University Year Marks / Div
 
Family Detail:
NameRelationship Age Sex M/FMartial Status Y/NSource of Income
 
 
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