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1. Name of Candidate(required)

2. Father's Name(required)

3. Email Id(required)

4. Mobile No(required)

5. Seeking Admission in

6. Social Category / सामाजिक वर्ग
General / सामान्यSC / अनुसूचित जातिST / अनुसूचित जनजातिOBC / अन्य पिछड़ा वर्ग

9. Type of Gender
MaleFemale

Date of Birth / जन्मतिथि(DD/MM/YYYY)

14. Current Location
Village / गांव

Panchayat & Block

Post / डाक

District / जिला

State / राज्य

Pin Code / पिन कोड

15. Accept
I hereby declare that information given above is true to the best of my knowledge. Any information, that may be required to be verified, shall be provided immediately before the concerned authority.