Hostel Registration Form Student Details Full Name: * PRN No.: * Gender: * Male Female Other Date of Birth: * Phone Number: * E-mail Address: * Name of College: * Please select college D Y Patil Medical College D Y Patil College of Nursing Center for Interdisciplinary Research D Y Patil College of Physiotherapy D Y Patil School of Hospitality D Y Patil College of Pharmacy D Y Patil School of Engineering and Management Name of Progamme: * Select Your Programme MBBS B.Sc. (Nursing) P.B.B.Sc. (Nursing) B.P.Th. (Physiotherapy) B.Sc. (Hospitality Studies) B. Pharmacy D. Pharmacy B. Tech. Computer Sciences and Engineering B. Tech. CSE (Data Science) B. Tech. Electrical Engineering B. Tech. Electronics and Telecommunication Bachelor of Computer Applications (BCA) Bachelor of Business Administrations (BBA) MD- Dermatology MD- General Medicine MD-Pathology MD-Radiology MD-Pediatrics MD-Anesthesia MD-Psychiatry MS-OBG & GYN MS-Orthopedics MS-General Surgery MS-ENT MS-Ophthalmology M.Sc. Stem Cells & Regenerative Medicine M.Sc. Medical Biotechnology M. Sc. Medical Physics M. Sc. Physics M.Sc. Medical Biochemistry M.Sc. Anatomy M. Sc. (Nursing) Child Health M. Sc. (Nursing) Obst and Gyn M. Sc. (Nursing) Community Health M. Sc. (Nursing) Mental Health M. Sc. (Nursing) Medical Surgical M.P.T. in Neurosciences M.P.T. in Musculoskeletal M.P.T. in Cardio-Pulmonary Science M.P.T. in Community M.P.T. in Sports M.P.T. in Orthopedic Manual Therapy Master of Business Administration (MBA) Masters of Computer Applications (MCA) PG DMLT Course. (Post B.Sc) Fellowship in Critical Care Medicine Fellowship in Dialysis Medicine Fellowship in Assisted Reproduction Fellowship in Endoscopic Sinus Surgery Fellowship in Pediatric Intensive Care Fellowship in Neonatal Intensive Care Fellowship in Minimal Access Surgery – Gynecology Fellowship in Minimal Access Surgery Fellowship in Chronic Pain and Palliative Care Fellowship in Obstetric Anesthesia Fellowship in Regional Anesthesia Fellowship in Spine Surgery Fellowship in Advanced and Complex Trauma Surgery Ph.D. Year of Study: * Select Year 1st Year 2nd Year 3rd Year 4th Year Parent Details Name: * Address: * Phone Number: * E-Mail Address: * Local Guardian Details Name: * Address: * Phone Number: * E-Mail Address: * Other Details Any medication you may taken: Any Special information to be share with rector/warden: Declaration: I agree & declare that all the information provided above is true and correct to the best of my knowledge. Submit Registration
