Faculty of Postgraduate Medicine

Internship Registration Form

All the fields are mendatory
Click here to track your application

Personal Information

Name*

Gender*

CID No.*

Date of Birth*

Email*

Present Address*

Phone No.*

Father Name*

Parent/Guardian No.*

Educational Details

Country*

Name of College*

Address of College*

Funding Agency*

Year of Graduation*

Documents Only pdf files can be uploaded

Final MBBS transcript*

Citizenship ID card*

NOC from parent Institute*

Class X Marksheet*

Class XII Marksheet*

Letter for Internship Program from DAHE *

UNDERTAKING BY THE APPLICANT

I, hereby confirm that the information provided above is correct. I understand that my application is liable to be rejected in the event misrepresentation of the facts/information provided above. *