Muniyal Ayurveda Group Institutions

0820 257 2819, +91 81234 03232, +91 81234 03233

info@muniyalayurvedacollege.com

34-C, Shivally Industrial Area, Manipal, Udupi, Karnataka 576104

123 456 789

info@example.com

Goldsmith Hall

New York, NY 90210

07:30 - 19:00

Monday to Friday

MIAMS Application Form

Date of Birth

Sex: MaleFemaleN/A

OBCCAT ICAT 2ACAT 2BCAT 3ACAT 3BGeneralSCST

Hostel Facility: RequiredNot Required

Details of the Examinations Passed

Name of the Examination University/ Board Year Marks obtained

/Maximum marks

% of Marks No. of attempts
High School/ or equivalent
II PUC or equivalent of 10 +2 level
BAMS-1st Prof.
BAMS-2nd Prof.
BAMS-3rd Prof.
BAMS-4th Prof.
Grand Total of all the Professional BAMS Examinations

Details of internship and other experiences as on or before:

Nature of Job Name of Hospital / Institution Duration

From                                                 To

Internship
Others

Date

Details of present employment, if any:

Name and full address of Employer Post Held Date of Joining Date of Confirmation
True Copy of Certificates to be attached at the time of Registration

  • AIPGET result sheet
  • S.S.L.C. Marks Card
  • BAMS Marks Card of all Phases/Years
  • Degree Certificate
  • Compulsory Rotatory Internship completion certificate
  • Council Registration Certificate
  • Eligibility certificate (for those who have completed BAMS from Universities other than RGUHS)
  • Six passport sized photographs
  • Transfer and Conduct certificate
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DECLARATION BY THE APPLICANT

I hereby agree, (if admitted) to obey the rules and regulations at present in force or that may be hereafter made for the governance of the college and its attached Hospital, and I undertake that I will not violate the rules of the College and Hospital and I will keep up the discipline.

Agree

DECLARATION BY THE PARENT / GUARDIAN

I do hereby declare that if my son / daughter / ward is admitted to the college, I bind myself responsible for his / her conduct, behaviour and prompt payment of fees or dues in the institution, and I also agree to abide by the final decision of the Principal in disciplinary matters, if any, in regard to my son / daughter / ward.

Agree