Application No.

: 90929024 ALIGARH MUSLIM UNIVERSITY

Session : 2025-26 GENERAL
Application Form for admission to
B.Sc. in Paramedical Courses / Diploma in
Paramedical Courses/ B.R.T.T.
Faculty of Medicine

PAYMENT NOT SUCCESSFUL, FORM NOT SUBMITTED Nationality: India , Domicile State:
Preference for Test Centres:
1. Aligarh (U.P.)
Personal Details:
Name: SAMEER KHAN Date of Birth: 04 April, 2007
Father's Name: GUDDU KHAN Gender: MALE
Mother's Name: KAMAR JAHAN Religion: Islam
Phone 1: 7417963376 Phone 2: 9675130350 Email: [email protected]
Details of Qualifying Examination: Status & Special Categories:
Examination: XII Status: EXTERNAL
Roll No.: 2225271310 Enrolment No.:
Year of Passing/Appearing: 2022 Hall:
Board/Univ.: UP Board of High School & Special Categories:
Intermediate Education, Allahabad
Percentage: 73.2%
Remark (if any).:
Is hostel accommodation required? YES#
Name of the Examination Board/University Year Roll No. % of Marks
XII UP Board of High School & Intermediate Education, 2022 2225271310 73.2
Allahabad
Address for Correspondence Permanent Address
NAGLA SARANGPUR, NAGLA SARANGPUR, NAGLA NAGLA SARANGPUR, NAGLA SARANGPUR, NAGLA
SARANGPUR SARANGPUR
PAHASU, BULANDSHAHR, BULANDSHAHR PAHASU, BULANDSHAHR, BULANDSHAHR
Uttar Pradesh, 202396, India Uttar Pradesh, 202396, India

DECLARATION: I SOLEMNLY UNDERTAKE to accept and abide by the rules of the Aligarh Muslim University and all the decisions of the Academic Council & other
appropriate University bodies in regard to my admission. I hereby solemnly affirm that I have gone through the Guide to Admissions & Supplements applicable for this
course and solemnly declare on oath that the entries made by me in the above columns are true to the best of my knowledge and belief and if at any time, the entries are
found incorrect, the admission may outrightly be cancelled and disciplinary action may be initiated against me.
# Hostel accommodation is not guaranteed; it is subject to availability of seats in the hostel

Application No. 90929024/OPBDA

For office use (Procotor's Office) For office use (DSW's Office)

Page 1/1

Powered by TCPDF (www.tcpdf.org)