BSS Admission Formadmin_website2023-03-31T06:23:28+00:00 Domain Applied For * Select CourseDiploma in Laboratory Technology (DMLT)Diploma in Operation Theatre Technology (DOTT)Certification in patient carePharmacy AssistantPhysiotherapy Technician Price: ₹250.00 Form Number: -- Submission Date: -- Basic Details Name * Date of Birth * Age * Gender * —Please choose an option—MaleFemaleOther Mobile Number * Email Address * Upload Passport-size Photo * Address Residential Location * City/Village * Police Station * Post Office * Block GP District * State * Pin Code * Personal Details Nationality * A/Cell # Adhar Card Number * Voter ID Number * Religion * Category * —Please choose an option—GeneralSCSTOBC Physically Challenge? * —Please choose an option—YesNo If yes, give details Marital Status * —Please choose an option—SingleMarriedOther Blood Group * —Please choose an option—O+A+B+AB+O-A-B-AB- Hostel Facility? * —Please choose an option—YesNo Guardian Details Father Name Cell Number Occupation Mother Name Cell Number Occupation Local Guardian Name * Cell Number * Occupation * Education Examination * Board/University * Marks% * Division * Medium of Institution * Year * NEXT Bank Details Bank Name: Axis Bank Account No.: 910010008420461 IFSC Code: UTIB0003586 Account Holder: Nirmet Upload payment slip of Rs.250 here * Back to Previous Form
