ADMISSION FORM FOR MBBS COURSE Session: 2020-2021
Name of the Candidate *
Candidate Photo
Max File Size 500kb. File format jpg,png only
MBBS Admit Card Serial.
Test Score
Merit Score
Merit Position
Quota
GeneralFreedom FighterForeignTribalPoor & Merit
Father's Name
Father's Service
Father's Income
Mother's Name
Mother's Service
Mother's Income
Age on 30th June, 201
Date of Birth
Place of Birth
Nationality
Religion
Permanent Address
Present Address
Mob/Tel (Father)
Mob/Tel (Mother)
Mob/Tel (Student)
Name of the Legal Guardian (If Father is dead)
Address
Relation
Occupation
Mob/Tel
Name of the Local Guardian (If Any)
Accommodation for Girls & Foreigner
SelfHostel
Examination passed
Name of Exam
GPA/Grade
Year
Total GPA Grade (Excluding Optional Sub.)
SSC/Equivalent
HSC/Equivalent
GPA in Biology in HSC
Form Which College You Have Passed Last Examination
Documents to be attached
Attested copies of mark sheets o S.S.C & H.S.C/ Equivalent Examinations
Max File Size 1MB, File format jpg,png, pdf only
Copy of Roll. No, Merit Score, Merit Position of the Examination Taken by DGHS
Copy of admit card & Applicat's copy of MBBS admission test exam
Citizenship certificate from local Chairman/Commissioner/NID/ Birth Certificate
Declarations: A) I, here by solemnly declare and legally bind myself to confirm to the Rules and Regulation of College at present in force or may hereafter be made and I undertake that so long I am a student of this college I will do nothing either inside or outside the College that will interfere with the discipline and the order of ordinances of Dhaka University relating MBBS course, syllabus and examination at present in force or that may hereafter be made to this effect.
B) If I am admitted on the basis of statement made in the above application and subsequently it is found that any of the statements are false. I shall be liable to be expelled from the College and all fess and other dues paid by me to the College up to that time shall be forfeited. I and my father/legal guardian would also be liable to any further departmental or legal action that the authorities may dem fit to take.
C) I further solemnly declare that there is no personal, domestic or financial circumstance which may prevent me form continuing my studies in this college until the completion of the entire course of studies.
D) I, further declare that I shall not do any activities subversive to the discipline of the institution and/or of the state (such as Strike, Hartal & Boycott etc.)
E) I, hereby certify that the above statement of particulars are true and correct.
Candidate Signature
I Agreed with above Terms and Conditions
