APOLLO INSTITUTE OF HOSPITAL ADMINISTRATION
(Affiliated to Osmania University and approved by AICTE)
(Sponsored by Apollo Hospitals Educational and Research Foundation) Affix your
Apollo Health City, Jubilee Hills, Hyderabad – 500 096.
recent
Tel: 23543269, 23607777/5007, Fax: 040-23608050, E-mail: info@[Link] Photograph.
APPLICATION FOR M.H.M ENTRANCE TEST 2010
DD No___________ Date________ Bank____________________ Place_____________ Rs.___________
(Writeyour name and father’s name as per your graduation certificate)
1. Name of the Candidate:
(In Capital Letters)
2. Name of the Father/Mother:
D D M M Y Y Y Y
3. Date of Birth
4. Reservation category, if any (put a mark)
ST SC BC–A BC–B BC–C BC–D BC–E GEN.
5. Residential Status (put a mark) Other
Local Non- Local
State
6. Gender (put a mark)
Male Female
7. Name of the qualifying examination passed:
(M.B.B.S., [Link]., [Link].,B.D.S, B.P.T. etc)
8. Percentage of Marks secured in the qualifying examination
9. Address for Communication
(In Block Letters)
Pin Code : _________________
District
State : _________________
Phone No With STD Code:_______________ Mobile No : _________________
E-Mail : _________________
P.T.O
10. Particulars of study of preceding seven (7) years starting from the qualifying examination.
S. No Course/ Class Year of study Scholl/College/University Place, District and State
11. Occupation of Parent / Guardian :
12. Annual income of parent / Guardian:
13. Permanent address :
Pin Code Mobile No.
Phone No.
Declaration: I hereby declare that the particulars furnished above are true and correct.
Date:
Place: Signature of the Candidate
**********************************************
Please Note:
1. Submit the application in duplicate (one for College and another for university)
2. Attach two 9”x4” size self addressed Covers affixing Rs. 5/- postal stamp on each cover
3. Keep seeing the website [Link] for information
4. Please sign the admit card (original and duplicate) before submitting application.
APOLLO INSTITUTE OF HOSPITAL ADMINISTRATION
(Affiliated to Osmania University and approved by AICTE)
Apollo Health City, Jubilee Hills, Hyderabad – 500 096.
Tel: 23543269, 23607777/5007, Fax: 040-23608050, E-mail: info@[Link]
M.H.M ENTRANCE TEST 2010. ORIGINAL ADMIT CARD
Admit Card Number
Affix
Recent
Date & time of Examination: Passport size
Photograph here
Place of Examination:
Name of the Candidate:
Sex (put a mark) Male: Female:
Signature of candidate Signature of convener
………………………………………………………………………………………
APOLLO INSTITUTE OF HOSPITAL ADMINISTRATION
(Affiliated to Osmania University and approved by AICTE)
Apollo Health City, Jubilee Hills, Hyderabad – 500 096.
Tel: 23543269, 23607777/5007, Fax: 040-23608050, E-mail: info@[Link]
M.H.M ENTRANCE TEST 2010. DUPLICATE ADMIT CARD
Admit Card Number
Affix
Recent
Date & time of Examination: Passport size
Photograph here
Place of Examination:
Name of the Candidate:
Sex (put a mark) Male: Female:
Signature of candidate Signature of convener