Registration Form
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Fill in the details and click on Submit to proceed.Use Mouse to move between fields for entry of data instead of using Tab Key.
Fields marked with*are mandatory.

Kindly enter Pincode registered in Adhar Card.

Click here to login .
*Do you have Aadhar Number:      Yes No
*Personal Details
*Name of the Applicant /आवेदक का नाम
*Applicant's Father name /पिता का नाम
*Other Personal Details
*Gender/लिंग    Male/पुरुष

*Date of Birth/जन्मतिथि

*Mobile No/मोबाइल नंबर *Email ID/ईमेल आईडी
*10th Roll Number/रोल नंबर     
*12th / Diploma (Roll Number/रोल नंबर)     
*Do you have Polytechnic Diploma Yes No

Please enter the letters displayed in the image below.
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Version 13.07.01