Online Application Form

Qualification


Qualification

% of Marks

Name of College

University

Year of Passing

M.B.B.S/ B.D.S (Aggregate of all the year)

M.D/M.S/DNB/MDS/Diploma (Aggregate of all the year)

M.Ch/DM (Aggregate of all the year)

Teaching Experience


Designation

Period From (Year)

Period To (Year)

Total No of Years

Name of the College

University

A) Tutor

   Junior Resident

   Senior Resident


B) Asst Prof/ Lecturer  1)

2)

3)

4)

C) Associate Professor   1)

2)

3)

Present status of Employment in medical college /Institution /Organisation


Achievement /Other information


Paper Publications (indexed journal)

a) National

b) International

c) Paper Presentations/ lectures in state/ national/ international conferences

d) University Gold Medal for PG Degree / WHO fellowship in the same subject

Total Marks Obtained:

Online Payment Details (Rs.2000/-)


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