Application Form : Divyansh Panchakarma Centre Sujanpur Himachal Pradesh

Name of candidate*

Father's/Husbands name*

Mother's name*

Date of birth*

Sex*

Category*

Marital Status*

Nationality*

Aadhar Card Number*

Mobile Number*

Guardian Number

Email Address

Correspondence Address*

Permanent Address*

12th Passed Detail

School*

Affiliation*

Marks Obtained (%) *

Upload Documents

Matric Certificate *

+2 Certificate *

Aadhar Card *

Category Certificate

Photo *

Declaration

I certify that the information provided by me is correct to the best of my knowledge if found false at any stage and If any students is found to be joined any similar or different full time course at elsewhere his/her admission will be deemed Cancelled .I also certify that no disciplinary action is going on against me and is not involved in any criminal activity .I also certify that I am fulfilling all the qualification and documents as per the advertisement .I also certify that I am physically and mentally fit to under go the training .I agree to pay the prescribed course fee and examination fee as per schedule . I also agree to accept all decision /directions given by the institute regarding admission/training/examination/results from time to time.