Personal Details

Full Name:

Surname:

Father Name:

Mother Name:

Gender: --Gender-- Male Female Other

Date Of Birth:

Nationality:

Email:

Phone number:

Phone number:

Emergency Contact:

Upload Photo (Resolution : 35mm*45mm or 3.5cm*4.5cm , Size : 600 dpi , Face visibility : 80% ,Colour : Black and White or Colour in matt finish with white background)

Passport Details

Passport Number:

Date Of Passport Issue:

Date Of Passport Expiry:

Place of Passport Issue:

Postal Address on passport with pincode:

Father Name:

Mother Name:

Identification (Scan copy of Passport both side front and back):

Educational Details

School Name

Year of Completion:

College Name:

Year of Completion:

HSC College Name:

Year of Completion:

Marks obtained in SSC:

Attach scan copy:

Marks obtained in 11^th:

Attach scan copy:

Marks obtained in HSC:

Attach scan copy:

Marks obtained in Physics:

Out of:

Marks obtained in Chemistry:

Out of:

Marks obtained in Biology:

Out of:

Marks obtained in English:

Out of:

Board Name & Division:

Attach scan copy:

Marks obtained in NEET:

Out of:

Attach scan copy:

Year of completion:

Attach scan copy:

University Preferences

Courses: --Select Courses-- MBBS

University Preferences:

I abide by the rules and regulations of AKEC

Enroll Now

Total Procedure

Details