CMC_Student

[1] Student Information *

Name [English] *

Gender *

Blood Group *

Mobile no.*

Password [For web portal login] *

Photo [MAX UPLOAD SIZE : 1 MB] *

Name [Bengali] *

Religion *

Marital Status

Email *

Confirm Password *

Quota

Date of Birth *

Nationality*

[2] Father's Information *

Name *

Name [Bengali] *

Annual Income of Guardian/Father & Mother (Tk) *

Profession *

Profession Type

Mobile (Office)

Mobile (Home) *

National ID No

[3] Mother's Information *

Name *

Name [Bengali] *

Profession *

Profession Type

Mobile (Office)

Mobile (Home) *

National ID No

[4] Local Guardian's Information

Name

Relation

Occupation

Mobile

Division

District

Upazilla/Thana

Union/Ward

Post Office

Post Code

Holding/Road/Block/Sector

House/Village

[5] Present Address *

Division *

District *

Upazilla/Thana *

Union/Ward

Post Office

Post Code

Holding/Road/Block/Sector *

House/Village *

Mobile

Full Address [Bangla] *

[6] Parmanent Address *

Division *

District *

Upazilla/Thana *

Union/Ward

Post Office

Post Code

Holding/Road/Block/Sector *

House/Village *

Mobile

Full Address [Bangla] *

[7] Academic information *

Course *

Session *

Batch *

Group *

Class Roll *

Date of Admission: *

Admission No *

University Reg. No.

Stipend *

Stipend Type

Board Scholarship *

[8] Previous Academic Information *

Name of Exam/Degree	Registration No	Roll No	Name of Institution [English]*	Name of Institution [Bangla] *	Session *	Board / University *	GPA / Division *	Year of Passing *

[9] Result of Optional Subjects in HSC/A level

GPA of Higher Math

GPA of Biology

GPA of Other

[10] Medical Admission Test Information *

Merit Position *

SSC GPA x 15

Roll No *

HSC GPA x 25

Merit Score *

Total Merit Score