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4 Please paste a passport size photograph of the Applicant APPLICATION FORM Application No.: For Admission to First Year / Direct Second Year B Pharm (Year - 20........ 20........) First Year D Pharm (Year - 20........ 20........) 1. Name of Candidate : (In BLOCK letters as it appears on the mark sheet of qualifying examination) uko nsoukxjh 2. Gender: Male Female 3. Date of Birth (dd/mm/yyyy) : 5. Place of Birth : 6. Name & Permanent Address of Parent / Guardian : 4. Tal Di.

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