Shri Balaji Para Medical College

Online Student Registration

Fill the registration form carefully. After successful submission your Registration Number will be generated and registration form will be available for printing.

1. Admission / Course Details

Admission Session *

Date of Admission *

Course Category *

Course *

Medium

2. Personal Details

Student Name *

Father's Name *

Mother's Name

Guardian Name

Date of Birth *

Gender *

Marital Status

Category

Aadhar Number

3. Contact Details

Mobile Number *

Parent's Contact

Email Address

4. Address Details

State *

District *

Permanent Pincode

Permanent Address

Correspondence Pincode

Correspondence Address

5. Academic Qualification

Education	Board / Institute	Passing Year	Total Marks	Obtained Marks
10th
12th
Graduation
Other

Last Qualification

Passing Year

6. Upload Documents

Student Photo

JPG / JPEG / PNG / WEBP

Student Signature

JPG / JPEG / PNG / WEBP

Aadhar Card / ID Proof

Image or PDF

Qualification Document

Image or PDF

Remarks

Declaration: I hereby declare that all information provided in this form is true and correct. Registration will remain subject to verification and approval by the institute.

I confirm that all information and uploaded documents are correct.