Application forms

    Course Applied for

    Date of Birth

    Gender

    Blood Group

    Religion

    Nationality

    Mother Tongue

    Community

    Present Address for Correspondence with Phone Nos.

    District

    Pin Code

    Land Line

    Mobile No

    Permanent Address with Phone Nos.

    District

    Pin Code

    Land Line

    Mobile No

    Native Place

    State

    E-mail Address

    Whether physically challenged person (Please mention)

    Reason for choosing this course

    Details of Parents / Guardian

    Father

    Mother

    Details of last school studied

    Extra Curricular Activities, if any

    Payment Details

    Please make the payment and enter the valid payment reference No

    Payment Mode

    Payment Reference No

    Payment Date

    Amount Paid

    Upload Reference Document (Pdf file only)

    Details of Educational Qualification including Additional Qualifications, if any. (Proof to be attached)

    Upload Transfer Certificate (PDF file only)

    Upload Hsc Mark Sheet (PDF file only)

    Upload Community Certificate (PDF file only)

    Upload Eligibility Certificate (PDF file only)

    Upload Migration Certificate (PDF file only)

    Upload Passport Size Photo (JPG file only)

    List of enclosures (Attested Xerox Copies)

    • Transfer Certificate
    • H.Sc Mark Sheet
    • Community Certificate
    • Eligibility Certificate obtained from the University for non Higher Secondary Courses, i.e., other
      than Higher Secondary of Tamil Nadu
    • Migration Certificate for non-H.Sc candidates i.e. other than H.Sc of Tamil Nadu
    • Passport Size Photograph

    Account Name : Sri Kauvery Medical Care India Limited

    Bank Name : State Bank of India

    Account Name : Sri Kauvery Medical Care India Limited

    Account No : 00000037172195953

    IFSC Code : SBIN0004060

    Branch Code : 04060

    Kauvery Hospital