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University
(Declared vide notification No. F.9-37/2007-U.3 (A) Dated. 29-2-2008 of the MHRD,
Government of India under Section 3 of the UGC Act, 1956)
Comprising Shri. B. M. Patil Medical College, Hospital and Research Centre,
Smt. Bangaramma Sajjan Campus, Sholapur Road, Bijapur – 586103, Karnataka, India.
Phone: +91-08352 – 262770, Fax: +91 – 08352 - 263303,
Website: www.bldeuniversity.org email: office@bldeuniversity.org
Recent
Application form for admission to Photograph
M.Sc programme in the Faculty of Medicine taken
within 6
months
4 Sex
5 Nationality
6 Date of birth
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Are you an employee of this
8
Institute ? If so furnish the details
I hereby declare that all statements made in this application are true, complete and correct to the best of
my knowledge and belief. I understand that in the event of any information being found false or
incorrect my candidature for M.Sc. programme is liable to be cancelled by the University.
Place:
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