Admission Form | Kailashnath College of Pharmacy

Ph. No. +91 9615150055

Email: office@kailashnathdpharma.in

Kailashnath College of Pharmacy

Deeha, Mehnagar, Azamgarh, U.P. – 276128

Admission Form

Online Registration

School:

Personal Detail

* Student Name:

* Gender:

Male

Female

Other

Date of Birth:

Religion:

Caste:

Blood Group:

Address:

Phone:

Email:

City:

State:

Country:

ID Number:

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Admission Detail

* Class:

* Section:

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Parent Detail

Father Name:

Father Phone:

Father Occupation:

Mother Name:

Mother Phone:

Mother Occupation:

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Login Detail

* Username:

* Login Email:

* Password:

Parent / Guardian Login Detail

Allow Parent Login?

* Username:

* Login Email:

* Password:

Transport Detail

Transport Route and Vehicle: