R.K. Devi Memorial Eye Research Institute, Kanpur

Course Name*

Fresh RPL

Name* Mr./Ms. [As per aadhar card]

Gender

Male Female

Father's/Mother's Name*

Address*

District*

State*

Pincode*

Mobile Number Student*

Mobile Number Father/Mother*

Email Address*

Aadhar Number*

Account Name*

Bank Name*

Account Number*

ISFC Code*

Religion*

Buddhist Christin Hindu Jain Muslim Sikh Others

Category*

General OBC SC ST Differently abled

Annual Income*

Below 1 Lakh 1-3 Lakh 3-5 Lakh 5 Lakh and above

Educational Qualification*

Upto 8th 10th 12th Graduate Post Graduate

Name of Compnay / Employer

Job Post

Total experience in years

Current salary(per month)