Snigdha Ayurvedic Hospital

APPLICATION FORM

(For Panchakarma Technician Course)

📘 Name of the Course: 📑 Advertisement No: 📂 Category applied for: 📷 Upload Photo (Self-attested):

💰 Fee Payment Details

Amount (Rs.): Bank DD No.: Dated:

👤 Personal Details

Full Name (CAPITAL letters): Father’s / Husband’s Name: 🏠 Present Address (for correspondence): 📧 Email ID: 📞 Mobile No.: 🏡 Permanent Address: 📅 Date of Birth: Age (as on closing date of application): 🌍 Nationality (Enclose Gov I.D): ⚤ Sex: 🗣️ Mother Tongue: 📖 Other Languages Known: 🏷️ Category (SC/ST/OBC/PWD):

📜 Educational Qualifications

Examination Passed	Name of the Board/University	Percentage of Marks	Distinction/Rank
10th/Secondary
12th/Sr. Secondary

📝 Additional Information:

✅ Declaration

I affirm that the information given in this application is true and correct. I understand that any attempt to conceal or misrepresent facts may result in the rejection or termination of my application.

📍 Place: ✍️ Signature of the Candidate: 📅 Date:

📌 Check-list

☑️ All details from column 1-10 duly filled.
☑️ Proof of Date of Birth attached.
☑️ Government ID attached.
☑️ Required category certificate attached.
☑️ Attested marks list and certificate attached.
☑️ Additional required documents, if any.
☑️ Two recent passport-size photographs.
☑️ Conduct certificate from the last attended institution.

APPLICATION FORM

(For Panchakarma Technician Course)

💰 Fee Payment Details

👤 Personal Details

📜 Educational Qualifications

✅ Declaration

📌 Check-list

Location

Our Contacts

APPLICATION FORM

(For Panchakarma Technician Course)

💰 Fee Payment Details

👤 Personal Details

📜 Educational Qualifications

✅ Declaration

📌 Check-list

Location

Our Contacts

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