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Allied Health Course Application Details

Rishikesh Kalla, a male student from Visakhapatnam, India, applied for Allied Health Courses and a BSc in Health Information Management. He paid 600 rupees by credit card. The application included his personal details, address, contact information, and a declaration that the information provided is true.

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rishikeshkalla
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13 views1 page

Allied Health Course Application Details

Rishikesh Kalla, a male student from Visakhapatnam, India, applied for Allied Health Courses and a BSc in Health Information Management. He paid 600 rupees by credit card. The application included his personal details, address, contact information, and a declaration that the information provided is true.

Uploaded by

rishikeshkalla
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

APPLICATION NUMBER 3619698 PAYMENT MODE CREDIT CARD

COURSE GROUP 13 AMOUNT 600


COURESES/APPLIED [Allied Health Courses & DD NUMBER NA
BSc HIM]
TEST CENTER NA DD DATE NA
DATE OF BIRTH 23/9/1999 CATEGORY GENERAL
SEX Male NATIONALITY India
NAME OF THE APPLICANT rishikesh kalla
NAME OF THE PARENT/ KALLA SRINIVAS RAO
GUARDIAN
ADDRESS LINE 1 45-40-28/A, AKKAYYAPALEM
ADDRESS LINE 2 80 Feet Road,
ADDRESS LINE 3 behind maharani parlour
PIN 530016 STD CODE/TELEPHONE NA
NUMBERS
CITY Visakhapatnam E-MAIL ADDRESS rishikeshkalla1998@g
[Link]
STATE Andhra Pradesh MOBILE NUMBER 919441517169
DATE OF COMPLETION OF NA
INTERNSHIP
EXAM REG NUMBER NA EXAM ROLL NUMBER NA
EXAM NAME NA EXAM SCORE NA
EXAM RANK NA
FOR MD/MS FOR MTECH
APPLICANTS APPLICANTS
ARE YOU A DIPLOMA NA ARE YOU A GATE SCORER? NO
HOLDER?

DECLARATIONS:
I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. I
have read and understood all provisions of admissions and agree to abide by them. I also affirm that I fulfil the eligibility
requirements for the course/s applied. In the event of submission of fraudulent, incorrect or untrue information or
suppression or distortion of any fact, like educational qualification, marks, nationality etc. I understand that my admission/
degree is liable for cancellation. I further understand that my admission is purely provisional subject to the verification of the
eligibility conditions.
NOTE:
[Link] keep a copy of the filled in application for future reference.
[Link] number must be quoted in all future correspondence.
[Link] candidates who are appearing for GATE exam should submit the valid score card on or before the last
date of receipt of application (For MTech / MSc Tech applicants only)
[Link] send this completed application form with DD/Challan(if payment is not via Credit Card) to: Director -
Admissions, Manipal University, Manipal - 576104

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