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VISHNU DENTAL COLLEGE

Bhimavaram-Vishnupur-534202

PERMITTED BY DENTAL COUNCIL OF INDIA, NEW DELHI

(No.DE-6(114)-Misc-III-2019/796)

APPLICATION FORM FOR ADMISSION TO DIPLOMA IN DENTAL MECHANIC COURSE

PLACE DENTAL LOGO

APPLICATION FORM FOR ADMISSION TO DIPLOMA IN DENTAL MECHANIC COURSE

Class Academic Year Month & Year of passing Percentage (%) Class

a.) Height
b.) Weight
c.) Vision
d.) Blood Group
e.) Details of any serious illness
Educational Qualifications Occupation Phone No. (including Mobile No.)
Father
Mother
Siblings

a.) Sports
b.) Cultural
c.) Any Other

Student Photo