All India Institute of Medical Sciences, New Delhi
Institute of National Importance Combined Entrance Test
(INICET)
January - 2026 Session
Application Form
Basic Details
Candidate Id 5766408889 Application Date Oct 8, 2025
Applicant's Name RAVI SHAH Registration Number 9162102772
Father Name SURENDRA PRASAD Mother Name SARITA DEVI SAH
SAH
Gender Male Marital Status Unmarried
Date of Birth Oct 1, 1998 Are you currently pursuing PG Medical/Dental No
course in any subject?
MD/MS/DM (6
Course Applied For Nationality Foreign National
YRS)/[Link](6 YRS)
I Have secured the OCI Card N/A OCI card issue date N/A
OCI card renew date N/A Applied Under Foreign National
Department N/A Institute Name PGIMER
CHANDIGARH
Do you want to apply for PGIMER, Chandigarh N/A PGIMER Department N/A
under Sponsored?
Do you want to apply for NIMHANS, Bengaluru N/A NIMHANS Department N/A
under Sponsored?
Do you want to apply for JIPMER, Puducherry
N/A JIPMER Department N/A
under Sponsored?
Do you want to apply for SCTIMST, Trivandrum
N/A SCTIMST Department N/A
under Sponsored?
Do you want to apply for AIIMS under
N/A AIIMS Department N/A
Sponsored?
AIIMS Institutes N/A Nationality Country Name Nepal
State of Domicile N/A Service in Central/State Govt. of 3 years or more N/A
Organization name N/A Joining Date N/A
End Date N/A Employment Type N/A
Do you belong to Karnataka Domicile N/A Are you Bhutani National Candidate? no
Category?
Service in Armed Forces N/A Belongs to North East Domicile State N/A
Category UR Category Certficate Issue date N/A
I do not have valid OBC certificate of the given Issue date of Acknowledgement Slip for renewal of
N/A N/A
date category certificate
Which facility do you require to appeare in the
PWBD No N/A
exam?
PWBD percentage N/A PWBD Category N/A
PWBD Sub Category N/A
ID Proof
Id Proof Id Proof Number Place of issue Issue Date Valid Till
MOFA, DEPARTMENT OF
Passport PA1879118 Oct 1, 2023 Sep 30, 2033
PASSPORTS
Contact Details
Phone no Alternate E-mail id Postal address Permanent address
no
JANAKPURDHAM , DHANUSHA , NEPAL, , , POKHARBHINDA,SAMSI 5 ,MAHOTTARI , NEPAL, , ,
9151611763 N/A ravisaa12580@[Link]
Other Other
Qualifying Exam Details
Qualifying Degree Equiavalent Degree Name Degree From Country Name
MBBS N/A Foreign University Nepal
University Name State Institute / College Name Other Institute / College Name
kathmamdu university (ku) N/A Birat medical college and teaching Hospital N/A
Date of Admission Passing Date Obtained Marks Maximum Marks
Dec 1, 2016 Dec 18, 2022 2691 4200
Obtained Percentage
64.07
Participating Institute Details
Have you done Under Graduate (UG) from participating institute ? Participating Institute Name
No N/A
Internship Details
Internship Status Start Date Completion/Expected Completion Date Number of Days
Completed Dec 27, 2022 Dec 27, 2023 366
Medical Registration Details:
Registering Authority Registration No Registration Date Registration Type State Authority of Registration
NMC 35237 Feb 15, 2024 Provisional N/A
Experience Details
S. Institute/Hospital Position Pay Place of Start End Length of Nature Of Is worked in Worked
Number Name Held Scale Posting Date Date service (Days) Duties Rural Area? In
No Experience Details Available
Examination State Choice
# First Preference Second Preference Third Preference Fourth Preference
State Bihar Uttar Pradesh Delhi Anywhere in India
Payment details
Mode Date Transaction id Amount
SBI Oct 10, 2025 B613160661906 4000
Certificates
Category Certificate Not Uploaded PWBD Certificate Not Uploaded
PWBD Appendix A-1/A-2/A-3 Certificate Not Uploaded OCI Certificate Not Uploaded
Upload Sponsored (Indian National) Certificate Not Uploaded Date of Birth Certificate
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