AMALA AYURVEDA HOSPITAL AND RESEARCH CENTRE

(An undertaking of Amala Cancer Hospital Society)

Amala Nagar P.O, Thrissur - 680555; Ph.No. 0487 230 3000, 9188303000

Fill this form only after payment of the application fee. For payment details see the prospectus

Application Form

Name of applicant (Block letters as in SSLC)

Date of Birth (DOB)

Name of Parent/Guardian (with relationship)

Occupation & Income of the Parent/Guardian

Present Address
Same as Present Address
Same as Present Address

Upload required files (maximum upload file size 1 mb / file)

Passport Size Photo
SSLC certificate
Qualifying Examination Certificate
Proof of Nativity

Payment Details

Date of Payment Amount (Rs.)

Declaration by the applicant

I hereby declare that the information furnished by me in this application is true and correct to the best of my knowledge and belief. I have carefully read the Prospectus and agree to abide by the rules and regulations governing admission to the Diploma Programmes in Ayurveda Allied Health Sciences under the Management Quota. I understand that any false information or suppression of facts may lead to the cancellation of my candidature/admission.