AIIMS Patna | Examination

Student Registration Form

Student Information

Course Name*

Session*

Admission Date* {As per admission letter generated by MCC (for MBBS) / AIIMS Portal (for Nursing)}

All India Rank (please don't enter category rank)*

First Name*

Middle Name

Last Name

Date of Birth*

Original Category*

Category Selected*

Gender*

Nationality*

Religion*

Mobile*

Email Address*

Email Address (Provided by AIIMS Patna)*

Identification Mark*

Blood Group*

Father's Name*

Mother's Name*

Upload Image*maximum file size allowed 50kb and image only

Upload Signature*maximum file size allowed 20kb and image only

Upload Admission Letter {Generated by MCC (for MBBS) / AIIMS Portal (for Nursing)}* maximum file size allowed 200kb and PDF only

Contact Details

Correspondence Address:

State*

District*

Town/Village*

Police Station*

Post Office*

Street Address*

Pin*

Land Line

Mobile (Parent/Guardian)*

Email (Parent/Guardian)*

Permanent Address:

State*

District*

Town/Village*

Police Station*

Post Office*

Street Address*

Pin*

Land Line

Mobile*

Email (Parent/Guardian)*

Emergency/Local Guardian Contact:

Guardian First Name

Guardian Last Name

Guardian Mobile No

Guardian Email Address

Relationship Type

Guardian Address

Educational Qualification

Matriculation

School Name*

State*

City*

Board*

Passing Year*

Total Marks*

Marks Obtained*

% of Marks*

CGPA

Division*

10+2

College/School Name*

State*

City*

Board*

Passing Year*

Total Marks*

Marks Obtained*

% of Marks*

CGPA

Division*

AIIMS Patna Student Management System

Student Registration Form

Student Information

Contact Details

Educational Qualification

Matriculation

10+2