S.D. COLLEGE OF PHARMACY

      BARNALA

ADMISSION APPLICATION FORM

FOR ADMISSION IN B –PHARMACY

NOTE: FILL THE APPLICATION FORM IN BLOCK LETTERS ONLY

1. NAME :                    _____________________________________

2. FATHER’S NAME   _____________________________________

3. DATE OF BIRTH :  _____________________________________

4. FULL CORRESPONDENCE ADDRESS (WITH TEL. NO.)        

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5. PERMANENT HOME ADDRESS :

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6. EDUCATIONAL QUALIFICATIONS:

7. MARKS IN QUALIFYING EXAM.(FOR PHARMACY COURSE ) MEDICAL/NON-MEDICAL

I SOLEMNLY DECLAREW THAT THE PARTICULARS GIVEN ABOVE BY ME ARE CORRECT TO BEST OF MY KNOWLEDGE & BELIEF.

PLACE :

DATE :                                               

                                                                                                  SIGNATURE OF CANDIDATE