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 :: Online Application Forms -> Application for the Issue of Eligibility Certificate
:: Results & Marks Statement
Results & Marks Statement
:: Convocation
Admit Card
Certificate Verification Despatch Details
:: Online Applications
Eligibility Certificate Application
Migration Certificate Application
Generalised All Fees -Application
Generalised All Fees -Application Status Check
:: Student Information
Student Information - List of Students
Student Information - List of Students with Details
 :: Admission Details
Course Type * UG PG Super Speciality
Course *
Year To Join
Studied Tamil as a subject in 10th/12th Yes No
Studied one subject in Urdu/Arabic.Persian Level at High school level or Equivalent/AFZALUL ULMA/ADEEB-E-FAZIL(URDU) recognized by University of Madras Yes No
College Sought for admission *
EC Year *
 :: Applicant's Details
Applicant's Name * Initials:
Father/Guardian's Name*
Gender *
Nationality *
Date of Birth *
Age(as on 31st December 2024)
(Original Birth/Transfer certificate to be enclosed)
Permanent Mobile No.*
Landline with STD Code
E-Mail
Community*
 :: Examination and E.C. Details
Exam Passed * Board * School * Place * State * District *
Vocational Stream * Hr.Sec.Roll Status* Register/Roll/Seat/Index No.* Month & Year of Passing *
-
Exam Passed * Reg.No * Date * TN Nursing Council Reg.No *
 
TN Nursing Council Reg.Date * TN Nursing Council Midwife Reg.No TN Nursing Council Midwife Reg.Date Month & Year of Passing *
    -
Exam Passed * University * University State * CRRI Period *
  -  
Council Name * Council State * Council Reg.No * Council Reg.Date * Month & year of Passing *
  -
To Delete Unwanted rows in the following table, Uncheck the checkbox available in the first column of the corresponding rows and click the "Delete Row" button.
 ::Marks Details
Subject English Physics Chemistry Botany Zoology Biology Maths Comp.Sci Vocational Aggregate D.Pharm I D.Pharm II B.Sc Nursing
Marks obtained *
Maximum Marks *
 :: Passport & VISA Details
Passport Details Passport No:    Expiry Date:
VISA Details VISA No:          Expiry Date:     
VISA Station:   Date of Arrival:
 :: Migration Details (For PG, Superspeciality and Allied Health courses)
Migration Certificate Details M.C No    :    Date:
University :  
 :: All India(AI) Quota Details
All India(AI) Quota allotted? Yes No
Allotment Order No:    Date:
 :: Medical Council Registration
Council Registration Details Council Name:    State: 
Reg.No:            Date :  
 :: Experience Certificate Details (if any)
Experience Certificate Details  From Date:  To Date:
 Name of the College/Hospital :  
 ::E.C. Delivery Details
Mode of E.C. Delivery *
Address to which E.C. is to be sent

 Pincode:
:: Payment Details
Amount Paid (in Rs.)*
For ex.: 100.00
Name of the Card Holder*
Mode of Payment* Non-IOB cards (Only VISA) IOB Debit and Credit Cards
  Note: MASTER CARD FACILITY WILL BE PROVIDED SHORTLY
 Service Charge/Commission :
 Bank Details*   Name of the Bank : 
  Place/Branch        : 
 Payment Details*   Challan/D.D No.    : 
  Payment Date      : 
Certificates Submission
Certificates Submitted
Certificate Submitted
HSC Or equivalent Mark statements
T.C
Community Certificate
Migration Certificate
TN Nursing Council Registration Certificate
TN Nursing Council Midwifery Registration Certificate
Medical Council Registration Certificate
Others(Pls. specify)
Upload Scanned Copies of Certificates
Total size of the Files uploaded should not exceed 4MB.
File Names should NOT contain Uppercase letters , dots, spaces,
and other characters like - ; ' " * & ^ $ # @ ! ~ ` ( ) + _ = % : < > ? /
Remarks
Medical College & University Management System
 
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