PARAMEDICAL ADMISSION : 2025
BBPT BMLT CCT BVIT PHA BHM CMS& ED DMLT PCT C&BPM OTT COURSES IN THE INSTITUTES OF ASSAM FOR THE SESSION 2025
COURSE OPTIONS
Choose any one of the following Course :
BPT
BMLT
PHA
PCT
CCT
BVIT
DIC
OTT
DMLT
BHM
CMS & ED
PERSONAL INFORMATION
Name of the Candidate :
* ( As per Certificate/Marksheet of HSSLC or equivalent )
Father's Name :
Mother's Name :
Sex :
Male
Female
Date of Birth:
Category :
GENERAL
OBC/MOBC
SC
STP
STH
EWS:
Yes
No
Are you Physically Handicapped : (Divyang)
Yes
No
Degree of Disability Percentage :
%
Nationality :
Indian
Others
Religion :
Hinduism
Islam
Christianity
Sikhism
Buddhism
Others
Physical Identification Marks :
1.
2.
Are you a Permanent Resident of Assam? :
Yes
No
COMMUNICATION INFORMATION
Current Address :
City :
Pin Code :
District :
State :
[SELECT]
01-Andaman and Nicobar Islands
02-Andhra Pradesh
03-Arunachal Pradesh
04-Assam
05-Bihar
06-Chandigarh
07-Chhattisgarh
08-Dadra and Nagar Haveli
09-Daman and Diu
10-National Capital Territory of Delhi
11-Goa
12-Gujarat
13-Haryana
14-Himachal Pradesh
15-Jammu and Kashmir
16-Jharkhand
17-Karnataka
18-Kerala
19-Lakshadweep
20-Madhya Pradesh
21-Maharashtra
22-Manipur
23-Meghalaya
24-Mizoram
25-Nagaland
26-Orissa
27-Puducherry
28-Punjab
29-Rajasthan
30-Sikkim
31-Tamil Nadu
32-Tripura
33-Uttar Pradesh
34-Uttarakhand
35-West Bengal
36-Telangana
Permanent Address :
As Above
City :
Pin Code :
District :
State :
[SELECT]
01-Andaman and Nicobar Islands
02-Andhra Pradesh
03-Arunachal Pradesh
04-Assam
05-Bihar
06-Chandigarh
07-Chhattisgarh
08-Dadra and Nagar Haveli
09-Daman and Diu
10-National Capital Territory of Delhi
11-Goa
12-Gujarat
13-Haryana
14-Himachal Pradesh
15-Jammu and Kashmir
16-Jharkhand
17-Karnataka
18-Kerala
19-Lakshadweep
20-Madhya Pradesh
21-Maharashtra
22-Manipur
23-Meghalaya
24-Mizoram
25-Nagaland
26-Orissa
27-Puducherry
28-Punjab
29-Rajasthan
30-Sikkim
31-Tamil Nadu
32-Tripura
33-Uttar Pradesh
34-Uttarakhand
35-West Bengal
36-Telangana
Mobile No. :
Email Address :
HSLC BOARD & MEDIUM
Select Your Board Name :
CBSE
SEBA
OTHER BOARD
Select Your Board Medium :
ASSAMESE
ENGLISH
OTHER MEDIUM
HSSLC EXAMINATION DETAILS
Date of passing HSSLC or Equivalent Examination :
Name of Educational Institution from where passed HSSLC or Equivalent Examination :
Name of Board/Council/University from where passed HSSLC or Equivalent Examination :
MARKS SECURED IN HSSLC OR EQUIVALENT EXAMINATION
Subject
Full Marks
Marks Obtained
Percentage
UPLOAD DOCUMENTS
Upload Photo
Upload Signature
Upload Qualification Certificate
Upload Aadhaar Card
FROM WHERE DID YOU COME TO KNOW ABOUT CIPS
Choose Your
Options :
Friends/Family
Newspaper
Internet
Radio/TV
Facebook
Instagram
Youtube
Twitter
DECLARATION BY THE CANDIDATE
I declare that above entries in the Application Form has been filled up by me and the entries made are correct as per my documents and to the best of my knowledge and belief. I agree that if any statement is proved to be false then the Authority shall have the right to take legal action against me for submitting false information or statement. I further declare that there is no allegation of misconduct against me and I have never been convicted for any offence involving moral turpitude.
Submit
Copyright © 2025 Crescent Institute Of Paramedical Studies. All rights reserved.