Student Personal Details
Candidate Name Sex
Father's Name Mother's Name
Postal Address Residence
Village
Post Office
Telephone No Nationality
Date of Birth Married
Whether Person with disability (a) If yes, percentage of disability : %
Category State/UT
Qualification Name of the Board
Duration of Study in Islands Examination Passed
Year of Passout Whether it is First Attempt
Attempt No.
Course Details
Course Applied (As per Annexure- A)
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Previously Nominated Area Applied Previously Institution
Have you appeared for NEET-2017
If yes (a) NEET-2017 Roll No
(b) State-merit/ranking of A&N Islands in NEET-2017
(c) NEET Marks
Details of Marks secured in Senior School Certificate (Class XII ) Examination
Roll No
SUBJECT MAX MARKS THEORY PRACTICAL TOTAL MARKS SUBJECT MAX MARKS THEORY PRACTICAL TOTAL MARKS
English History
Physics Geography
Chemistry Political Science
Biology
Mathematics
Computer Science
Hindi
Economics Total Marks    
Class XII Percentage (%)
Details of Marks secured in Secondary School Certificate -Class X (Mandatory for Candidates Applying for Diploma Courses)
Roll Number
Sl. No. SUBJECT MAX. GRADE POINTS GRADE POINTS OBTAINED MAX. MARKS MARKS OBTAINED
1. ENGLISH
2. HINDI/OTHER LANGAUGE
3. MATHEMATICS
4. GENERAL SCIENCE
5. SOCIAL STUDIES
Total Marks
Class X Percentage (%) CGPA
Details of any other Examination Passed
University Degree (If any)
Name of College / University
Subject
Percentage of Marks (Aggregate %)
Division in which passed
Have you appeared the Common Entrance Exam (CEE)-2017 conducted by Regional Institute of Education:   (a) If yes,   Enter the marks Obtained :  OR  Enter the Rank Obtained :
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