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    Medigal Application

    Uploaded by

    Maniyamuthan
    This document is an application form for admission to paramedical degree courses in Tamil Nadu for the 2023-2024 session. It contains details of the applicant such as personal information, educational qualifications, family details, contact information, and a declaration signed by the applicant. The applicant is female, has secured good marks in her HSC examination, and is seeking admission as a first graduate from her family.

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    © All Rights Reserved
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    Medigal Application

    Uploaded by

    Maniyamuthan
    36 views2 pages
    This document is an application form for admission to paramedical degree courses in Tamil Nadu for the 2023-2024 session. It contains details of the applicant such as personal information, educational qualifications, family details, contact information, and a declaration signed by the applicant. The applicant is female, has secured good marks in her HSC examination, and is seeking admission as a first graduate from her family.

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    This document is an application form for admission to paramedical degree courses in Tamil Nadu for the 2023-2024 session. It contains details of the applicant such as personal information, educational qualifications, family details, contact information, and a declaration signed by the applicant. The applicant is female, has secured good marks in her HSC examination, and is seeking admission as a first graduate from her family.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    36 views2 pages

    Medigal Application

    Uploaded by

    Maniyamuthan
    This document is an application form for admission to paramedical degree courses in Tamil Nadu for the 2023-2024 session. It contains details of the applicant such as personal information, educational qualifications, family details, contact information, and a declaration signed by the applicant. The applicant is female, has secured good marks in her HSC examination, and is seeking admission as a first graduate from her family.

    Copyright:

    © All Rights Reserved
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    GOVERNMENT OF TAMIL NADU

    DIRECTORATE OF MEDICAL EDUCATION


    SELECTION COMMITTEE
    Paramedical Degree Courses Session :2023 - 2024
    AR.NO :
    Application No. : 23PMC505867
    (To Be Assigned By the Selection Committee)
    EMIS ID Number : 1006845291
    1 Hsc/Equivalent Reg/Roll no : 2212145144
    Year of Passing : 2023
    2 Name : RUTHRAVENI M
    3 Parent Name : MANI M
    4 Date of Birth : 08-06-2006
    5 Gender : FEMALE
    6 Nationality : INDIAN
    7 Religion : HINDU

    8 Mother Tongue : TAMIL

    9 Nativity : Tamil Nadu 10. Community : MBC&DNC


    Sub Caste with Code : Piramalai Kallars (DNC)-45
    THENI -
    11 Certificate No : TN-52022062116135 Issued Taluk
    UTHAMAPALAYAM
    Issued By : Zonal Deputy Tahsildar Issued Date : 03-07-2022
    12 Special Reservation Information
    a) Ex Servicemen : NO
    b) Differently Abled Person : NO
    13a) Whether studied from 6th to 12th in Tamilnadu? : YES
    b) Whether studied from 6th to 12th in Tamilnadu Government School or : NO
    RTE?
    14 Qualification Examination HSC Group Code ( Tn State only) : 2503
    15 Name of the Board of Examination : Tamilnadu-Tamilnadu Board of Higher Secondary
    Education
    16 Passed all the subjects of HSC / Equivalent exam in no of attempts. : 1 - Passed all the subject in First Attempt
    17 Marks Obtained in HSC (Academic/Equivalent) Examination
    Subject Register Number Month Year Maximum Mark Obtained Mark
    English 7145230 Mar 2023 100 86
    Physics 7145230 Mar 2023 100 98
    Chemistry 7145230 Mar 2023 100 96
    Biology 7145230 Mar 2023 100 96
    Mathematic 7145230 Mar 2023 100 88
    18 UnderGoing / Completed any professional courses : NO
    a) If yes mention name of the course : NO
    19 Medium Of Instruction : TAMIL
    Civic Area of the Last School Studied : Village
    20a) : b) Civic (Native) : Village Panchayat
    Panchayat
    21) School of Study Information
    Class Year of Name of the School District State School Type
    Passing
    VI 2017 SUM HR SEC SCHOOL ROYAPPANPATTI THENI TAMIL NADU FULLY AIDED
    VII 2018 SUM HR SEC SCHOOL ROYAPPANPATTI THENI TAMIL NADU FULLY AIDED
    VIII 2019 SUM HR SEC SCHOOL ROYAPPANPATTI THENI TAMIL NADU FULLY AIDED
    IX 2020 SUM HR SEC SCHOOL ROYAPPANPATTI THENI TAMIL NADU FULLY AIDED
    X 2021 SUM HR SEC SCHOOL ROYAPPANPATTI THENI TAMIL NADU FULLY AIDED
    XI 2022 SUM HR SEC SCHOOL ROYAPPANPATTI THENI TAMIL NADU FULLY AIDED
    XII 2023 SUM HR SEC SCHOOL ROYAPPANPATTI THENI TAMIL NADU FULLY AIDED

    22 Are you a First Graduate Applicant : YES


    23a) Parent Occupation : Others : b) Parent Annual Income : Below Rs. 1,00,000
    1/WARD7, MAIN ROAD, EZHUVAMPATTI,
    24 Address For Correspondence : CHINNAOVULAPURAM, UTHAMAPALAYAM TALUK
    THENI DISTRICT THENI TAMIL NADU -625515
    25 Native District : THENI : Native State : Tamil Nadu
    26 Aadhar Number : 662410750225
    27a) Email Id : manimanimani123412341234@gmail.com : b) Phone Number : 8695258010
    28 Payment : Amount=500.00, TrackID=0656129318629
    I do hereby solemnly affirm that the statement made and information furnished in my application form and in all the
    enclosures thereto submitted by me are true. Should it however be found that any information furnished therein is untrue in
    particulars, or there has been suppression of facts. I realize that I am liable for criminal prosecution and I also agree to forego
    my seat in the College at any time during the course of my study.

    If I failed to produce any necessary documents at any stages of counselling / admission or any wrong information furnished in
    the application form, I aware that the selection committee has rights to disqualify me and remove from this year admission
    and merit list.

    Place :
    (Signature of Applicant)
    Date :

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