APPENDIX I

Instructions for filling in the Basic Data Sheet

Note:

The Basic Data Sheet must be filled in terms of codes, in capital letters or numericals as explained below. Not more than one numerical should be written in any one box. Start filling the form from item 1 only. The Roll Number will be filled in by the office.


Item 1. Write your name as filled in application form.

Item 2. Write your full mailing address in block letters along with the pin code for correspondence.

Item 3. Write the date/due date of completion of Internship in terms of date, month and year,
e.g. if date of completion of Internship is 15th January, 1990 fill in.

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1    5    0    1    9    0

Item 4. Indicate your date of birth in terms of date, month and year. For e.g. if the date of the birth is 29th August 1961 you fill in. Indicate your date of birth in terms of date, month and year.
For e.g. if the date of the birth is 29th August 1961 you fill in.

2    9    0    8    6    1

Item 5. Write the code for the college from which you have obtained MBBS degree from the list given below.

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