DPR - MEDI PLAN

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DPR - MEDI PLAN

Campus Zap Unit? *

Name of the Student? *

Spoke to? *

Decision Maker? *

Student Date of Birth? *

YYYY

Students Domecile State? *

Students Category? *

Phone Number 1? *

Phone Number 2?

WhatsApp Number?

Email Address? *

Interested Institution/s *

A J Shetty Institute of Medical Scinces, Mangalore, Karnataka

Adichunchangiri Institute of Medical Sciences, Belur Cross, Mandya, KA

Akash Institute of Medical Sciences, Bangalore, KA

BGS Global Institute of Medical Sciences, Bangalore, KA

Dr. B R Ambedkar Medical College, Bangalore, KA

Father Mullar Medical College, Mangalore, Karnataka

K V G Medical College, Sullia, KA

Kanachure Institute of Medical Sciences, Mangalore, Karnataka

Oxford Institute of Medical Sciences, Bangalore, KA

Saptagiri Institute of Medical Sciences, Bangalore, KA

Sridevi Medical College, Tumkur, KA

Srinivasa Institute of Medical Sciences, Mangalore, Karnataka

Vydehi Institute of Medical Sciences, Bangalore, KA

All India Counselling

Other State Counseling

Deemed University / MCC Counseling

Required

NEET Attempt? *

Obtained Neet Score 2023? *

Expected / Obtained NEET Score 2024? *

Available Budget? *

Mode of Service Required?
*

DPR Story?
*

Appointment Schedule Date? *

YYYY

Appointment Schedule Time? *

Time

DPR to be assigned to?
*

Employee Signature
*

Submit

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