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Medical Course

Nursing

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Student ID *

Student Name *

Roll Number *

Regi. Number *

DOB

Student's Email

Student's Phone *

Father's Name *

Father's Phone

Mother's Name

Mother's Phone

Permanent Address

Present Address

Present Guardian's Name

Present Guardian Phone

Academic Course *

Department *

Admission Date *

Admission Fees

Total Course Fees *

Duration(Month) *

Additional Fees

Notes

Stipend *

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Agreement *

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SL	Title	Amount	Remarks	Date
1	Collage Admision	4250	06/09/20- NUR-013870060920/ D-10645	07/09/20 02:09 pm