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Online Admission Form - 2021-2022
Contact us : +424-2339929, 2339538, +91-98434 92100, 94423 24397
Email :
ecperode@gmail.com
,
ecperode@hotmail.com
Website :
www.ecperode.in
* Indicates required question
Name of the Student
*
First and last name
Your answer
(+2) Register Number
*
Your answer
Gender
*
Female
Male
Required
Date of Birth
MM
/
DD
/
YYYY
Father's Name
*
First and last name
Your answer
Occupation
*
First and last name
Your answer
Phone Number (or) Mobile Number
*
Your answer
Email
*
Your answer
HSc (+2) Mark
*
Your answer
Cut off Marks (Physics, Chemistry, Biology)
*
Your answer
Courses
*
Pharm.D. (6 Years Duration)
B.Pharm (4 Years Duration)
M.Pharm (2 Years Duration)
D.Pharm (2 Years Duration)
Required
Address
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State
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Community
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SC
ST
BC
BCM
MBC
OC
Others
Caste
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Last Studied (Name of School or College)
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Hostel Required
*
Yes
No
Required
College Bus Required
*
Yes
No
Required
If any Queries, Write to us
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