Academic Year*
Name*
Email
Gender	MaleFemale
Address*
Tel.no	(Numbers only)
Mobile no	(Numbers only)
Pin code	(Numbers only)
date of birth*
place of birth*
Category*	---Select Category--- Open OBC SC ST VJNT NT
Sub cast*
Whether Domicile of Maharashtra*	Yes No
Blood group

Mark Secured in the qualifying examination (Numbers only)
physics*		Biology*
Chemistry*		Maths*
English*		Computer science
Biotechnology		Total marks in PCM*

Grand Total Marks (Numbers only)
XIIth*	Out of
Xth*	Out of
Xth maths marks*	Out of
Marks Obtained in MAH-PH-CET-AIEEE*