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APPLICATION FORM FOR REGISTRATION FOR INDIAN NATIONALS QUALIFIED FROM FOREIGN INSTITUTIONS
(ONLY FOR DOMICILE OF MAHARASHTRA)
Instructions For How to apply Parmenent Registration For Foreign Graduate
Step 1
Step 2
Step 3
Step 4
Application Type
---Select---
Permanent Registration (Foreign Graduate)
Provisional Registration (Foreign Graduate)
Provisional Details
Authority Council Name
*
State
Email id Of authority council
Provisional No
*
Provisional Date
Application Details
pplication No
*
ApplicationDate
Personal Details
Name
Father's Name
*
Mother's Name
*
Marital Status
*
---Select--
Single
Married
Gender
*
---Select---
Male
Female
Maiden Name
*
Husband's Name
*
Date of Birth
*
Place of Birth
*
District
*
State
*
Domicile in Maharashtra?
*
---Select---
Yes
No
Contact Details
Full Present Address
*
Taluka
*
District
*
State
*
Country
*
Pin Code
*
FaX NO
Mobile No
*
Email Id
*
Residential No
Clinic No
Category (General or Reseve i.e. SC/ST/OBC/Other)
*
Nationality
*
Indian
10th Class/Matric/High school
School Name
School Address
Board Name
Board Address
Roll No
Result
Yes
No
Certificate No
Certificate Date
Marks Marks (Obtained/Total)
Percentage
11th Class
School Name
School Address
Board Name
Board Address
Roll No
Result
Yes
No
Certificate No
Certificate Date
Marks Marks (Obtained/Total)
Percentage
12th Class/Intermediate or 10+2
School Name
School Address
Board Name
Board Address
Roll No
Result
Yes
No
Certificate No
Certificate Date
Marks Marks (Obtained/Total)
Percentage
B.SC. OR ANY OTHER UNIVERSITY EXAMINATION.
College Name
College Address
University
Roll No
Date of Joining
Date of Passing
Examination Passed
Medical Qualification
Name of Institute
Address of Institute
Registration Number/ (OVIR NO.)
Address of SENTRALNIYA OVIR (Registration Deptt.-OVIR) (Ministry of Foreign Affairs or Interior Ministry City)
Registration Valid from
Registration Valid upto
Medium of instruction
Have You done any part of your medical course in india, or any country than where you have obtained Medical degree as mention in application, If Yes ,its duration and Location
Yes
No
Passport Details
Passport No
Date of issue
Place of issue
Address as on passport
Visa issued by (name of Country)
Nature of Visa
Date of Validity from
To
Date of leaving India
Date of returning to india
Did You ever Change/Loss the passport due to any reason
Yes
No
Screening Test Particulars
Name of Board
---Select---
National Board of Examination New Delhi. (Ministry of Health, Government of India)
Date of passing
Roll no
Marks obtained
Out of
Internship Training Particulars
Name of Training Institute
Address
State
Whether Recognized by MCI
Yes
No
Date of Training from
To
Total Present in Days
NAME OF THE MEDICAL DEGREE / DIPLOMA OBTAINED AND UNIV. / LICENSING BODY WITH THE YEAR OF
WHETHER SHE / HE HAS UNDERGONE PRACTICAL TRAINING BEFORE OR AFTER OBTAINING THE MEDICAL QUALIFICATION REQUIRED BY THE RULES OF THE CONCERNED FOREIGN COUNTRY
Yes
NO
IF YES, GIVE DETAILS.
WAS ANY MEDICAL COLLEGE / SCHOOL IN INDIA ATTENDED BEFORE DEPARTURE FROM INDIA, (GIVE NAMES OF PERIOD OF STUDY UNDERGONE AND EXAMINATION PASSED).
IN THE LANGUAGE OF STUDY IN THE COUNTRY BE OTHER THAN ENGLISH, PLEASE INDICATE IF IT WAS STUDIED IN INDIA BEFORE DEPARTURE OR WAS STUDIED IN THAT COUNTRY. PLEASE INDICATE THE TIME TAKEN FOR THAT STUDY AND WHETHER ANY EXAMINATION WAS PASSED.
DO THE MEDICAL EXAMINATION (S) PASSED IPSO FACTO ENTITLE ONE TO REGISTER IN THE COUNTRY IN WHICH THEY WERE TAKEN OR A SEPARATE EXAMINATION FOR REGISTRATION HAS TO BE PASSED.
ARE YOU REGISTERED IN ANY FOREIGN COUNTRY?
Yes
NO
Register Body
Registration Number
Date OF Registration
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