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    Registration Slip

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    DOC M
    Javed Akhtar Sarkar from West Bengal has applied for admission to postgraduate medical courses including MD/MS at the All India Institute of Medical Sciences for the January 2023 session. He completed his MBBS degree from Nilratan Sircar Medical College, Kolkata in 2020 and has since completed his internship and obtained medical registration in West Bengal. His preferred examination cities are Kolkata, Siliguri, and Asansol.

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    Registration Slip

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    DOC M
    57 views2 pages
    Javed Akhtar Sarkar from West Bengal has applied for admission to postgraduate medical courses including MD/MS at the All India Institute of Medical Sciences for the January 2023 session. He completed his MBBS degree from Nilratan Sircar Medical College, Kolkata in 2020 and has since completed his internship and obtained medical registration in West Bengal. His preferred examination cities are Kolkata, Siliguri, and Asansol.

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    Javed Akhtar Sarkar from West Bengal has applied for admission to postgraduate medical courses including MD/MS at the All India Institute of Medical Sciences for the January 2023 session. He completed his MBBS degree from Nilratan Sircar Medical College, Kolkata in 2020 and has since completed his internship and obtained medical registration in West Bengal. His preferred examination cities are Kolkata, Siliguri, and Asansol.

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

    Registration Slip

    Uploaded by

    DOC M
    Javed Akhtar Sarkar from West Bengal has applied for admission to postgraduate medical courses including MD/MS at the All India Institute of Medical Sciences for the January 2023 session. He completed his MBBS degree from Nilratan Sircar Medical College, Kolkata in 2020 and has since completed his internship and obtained medical registration in West Bengal. His preferred examination cities are Kolkata, Siliguri, and Asansol.

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    10/14/22, 1:53 PM https://finalmdmsmch.aiimsexams.ac.in/RegistrationSlip?

    id=F/0gUr7pYTsDm57zzp0Z2ih+8hL7zYdqRiDklO8EfI0lEaF2FJGP

    All India Institute of Medical Sciences


    Ansari Nagar, New Delhi - 110608

    Registration Form - Institute of National Importance Combined Entrance Test (INI-CET) for admission to PG courses [MD/MS/M.Ch.(6years)/DM(6years)/MDS]
    Jan 2023 Session

    Candidate Profile Registration ID: P6181476454 Payment ID: 30022179 Examination Unique Code: 9122262

    Candidate Name: SARKAR JAVED AKHTAR Applied Course: MD/MS/MCH(6YRS)/DM(6YRS)

    Date of Birth: 18 Nov 1997 Category: OBC (NCL)

    Gender: Male Marital Status: Unmarried

    Father's Name: MATIFUR RAHAMAN Mother's Name: JAHANARA BEGUM

    PWBD Status: No PWBD Category: NA

    Nationality: INDIAN Applied Under: Indian National

    Identification Mark(1): Black mole over nose Identification Mark(2):


    Black mole over right cheek

    Are you currently pursuing PG Course in any Subject: NO Do you belong to Karnataka Domicile Category:
    NO

    Do you belong to North East Domicile Category: NO Do you want to apply for Bhutani National
    Candidate : NA

    Service in Armed Forces (as per note 3 of Appendix-E)?: NA Service in Central/State Govt. of 3 years or more
    (as per note 3 of Appendix-E)? : NA

    Applied for PGIMER,Chandigarh under Sponsored Category (Indian National)?: NA Applied for JIPMER,Puducherry under
    Sponsored Category (Indian National)? : NA

    Applied for AIIMS(Delhi/Rishikesh) and SCTIMST, Trivandrum under Sponsored Do you want to apply for NIMHANS,Bengaluru
    Category (Indian National)?: NA under Sponsored Category(Indian National) : NA

    Contact Details

    Address for Permanent: Correspondence Address:


    BIRENDRA SOVA APARTMENT, BIRENDRA DUTTA LANE, UKILPARA, RAIGANJ, Raiganj , North 138 AJC BOSE ROAD,SEALDAH, Intally , Kolkata, WEST
    Dinajpur, WEST BENGAL, India, 733134 BENGAL, India, 700014

    Mobile No: 1. 7063884333 , 2. Alternate-MobileNo 0 E-Mail ID: withethan906@gmail.com

    Qualification Details

    Qualifying Examination Degree From State Name Admission Date Passing Date

    MBBS Indian University West Bengal 01/08/2015 04/08/2020

    University Name Institute/College Name


    WEST BENGAL UNIVERSITY OF HEALTH SCIENCES Nilratan Sircar Medical College, Kolkata

    Academic Details

    Qualifying Exam Max Marks Marks Obtained Percentage(%)


    MBBS 2450.00 1401.00 57.18

    Internship Details

    Internship Status Internship Start Date Completion/Expected Completion Date No. of Days
    Completed 10/08/2020 09/08/2021 365

    Medical Registration Details

    Registration Type Registration Date Registration Number Registering Authority


    Permanent 01/09/2021 88468 State Council -- (West Bengal )

    Valid Photo Identity (To be presented in original at the Examination Center along with Admit Card)

    ID Proof: Adhar Card ID No: 481935170062 Place of Issue: INDIA Issue Date: NA Valid Till: NA

    Do you have experience : No

    Payment Details

    Mode: Online Date: 14/10/2022 Transaction ID: 14764541017 Amount: 4000

    Examination City Opted:

    https://finalmdmsmch.aiimsexams.ac.in/RegistrationSlip?id=F/0gUr7pYTsDm57zzp0Z2ih+8hL7zYdqRiDklO8EfI0lEaF2FJGP 1/2
    10/14/22, 1:53 PM https://finalmdmsmch.aiimsexams.ac.in/RegistrationSlip?id=F/0gUr7pYTsDm57zzp0Z2ih+8hL7zYdqRiDklO8EfI0lEaF2FJGP

    State: Exam City(Preference 1): State : Exam City(Preference 2): State : Exam City(Preference 3): Exam City(Preference 4):

    WEST BENGAL KOLKATA WEST BENGAL SILIGURI WEST BENGAL ASANSOL Any Other City

    UNDERTAKING/DECLARATION: I hereby declare that the information furnished by me in the Registration/Application Form is correct and nothing has been
    concealed. In case any information furnished by me is found to be false/incorrect/untrue than i shall be liable to civil/criminal prosecution and my claim to
    admission/appointment/registration/ service in the Institute may be cancelled/terminated.

    Signature of Candidate
    Thumb of Candidate

    https://finalmdmsmch.aiimsexams.ac.in/RegistrationSlip?id=F/0gUr7pYTsDm57zzp0Z2ih+8hL7zYdqRiDklO8EfI0lEaF2FJGP 2/2

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