Amala Institute of Medical Sciences

iA AIMS Online Application Form

Application form for 2024 - 2025

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Student Database

Name:

DOB:

Date of Admission:

PG Department:

Blood Group:

Admission Category:

Course:

Nationality:

Religion:

Belongs to:

Caste:

Gender:

Email id:

Mobile No:

Whatsapp No:

Landline No:

Marital Status:

Place of birth:

Nativity:

Annual income of parents:

Period of internship from:

Period of internship to:

TCMC reg Details:

TC obtained from(Name & Year):

Migration certificate no:

Equivalency certificate no:

KEAM roll no:

KEAM Rank:

Physically handicapped:

Dependent of Ex-Serviceman:

Height ( in cms):

Weight (in Kg):

Communication Address:

Permanent Address: (Same as Communication Address)

Pin Code:

District:

State:

Pincode:

District:

State:

Father's Name:

Mother's Name:

Father's Occupation:

Mother's Occupation:

Father's Mobile No:

Mother's Mobile No:

Father's Whatsapp No:

Mother's Whatsapp No:

Father's Education:

Mother's Education:

Email id of parent:

Hobbies:

Extra curricular activities:

Aadhaar No:

Pancard No:

Neet Roll No:

Neet Rank:

Neet max_mark:

Neet mark scored:

Neet percentile:

Authority of entrance test:

College last attended:

Proposed Residence:

Member from family in the same profession:

Details of the Qualifying Exam

Name of the Course:

Name of the institution:

Name of the university / board:

Month and Year:

Reg No:

Percentage of marks:

Number of attempts:

Name of the Course:

Physics

Chemistry

Biology

English

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