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NADU DR. M.G.R. MEDICAL UNIVERSITY No. 69, Anna Salai, Guindy, Chennai 600 032. APPROVED BY REHABILIATION COUNCIL OF INDIA APPLICATION FOR ADMISSION TO BASLP Name of the Course : Year of Admission : 1. Name of the Candidate In BLOCK LETTERS (as entered in the Higher Secondary Certificate) : Passport size Photograph (a) Expansion of Initials: (b) Name in Tamil : 2. Sex : 3. Date of Birth (Christian Era) : (Evidence should be enclosed) The candidate should have completed 17 Years of.

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