SIMS- Shimoga
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SHIMOGA INSTITUTE OF MEDICAL SCIENCES [SIMS], SHIMOGA
ADMISSION APPLICATION FOR POST GRADUATE [P.G.] FOR THE ACADEMIC YEAR 2022-23
Personal Information
P.G. Subject
MD Anaesthesiology
MD Anaesthesiology
MD Anatomy
MD Biochemistry
MD Dermatology Venerology & Leprosy (DVL)
MD Forensic Medicine
MD General Medicine
MD Microbiology
MD Paediatrics
MD Pathology
MD Pharmacology
MD Physiology
MD Preventive & Social Medicine
MS General Surgery
MS OBG
MS Orthopaedics
MS Otorhinolaryngology
MS Ophthalmology
MD Radiodiagnosis
Name of the Candidate
Mother Name
Father Name
Father Occupation
Mother Occupation
Annual Income
Parent Mobile No
Date of Birth
Gender
Female
Male
Religion
HINDU
CHRISTIAN
ISLAM
JAIN
BUDDHIST
OTHER
Caste
Sub Caste
Category
Select Category
GM-General Merit
SC-Scheduled Caste
ST-Scheduled Tribe
C1-Category-I
2A-Category-2A
2B-Category II B
3A-Category 3A
3B-Category III B
OBC
Mother Tongue
Address
City
State
State
Karnataka
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Goa
Gujarat
Haryana
Himachal Pradesh
Jharkhand
Kerala
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
Telangana
Andaman and Nicobar
Chandigarh
Dadra and Nagar Haveli
Daman and Diu
Jammu
Laddakh
Lakshadweep
New Delhi
Puducherry
Student Mobile Number
Email Address
Blood Group
A +ve
A -ve
B +ve
B -ve
AB +ve
AB -ve
O +ve
O -ve
Aadhar Number
Student Bank
Abu Dhabi Commercial Bank Ltd.
Allahabad Bank
American Express Bank Ltd.
Andhra Bank
Antwerp Diamond Bank N.V.
Arab Bangladesh Bank Limited
Axis Bank
Bank Internasional Indonesia
Bank of America N.A.
Bank of Bahrain & Kuwait BSC
Bank of Baroda
Bank of Ceylon
Bank of India
Bank of Maharashtra
Barclays Bank Plc
BNP PARIBAS
Calyon Bank
Canara Bank
Catholic Syrian Bank Ltd.
Central Bank of India
Chinatrust Commercial Bank Ltd.
Cho Hung Bank
Citibank N.A.
City Union Bank Ltd.
Coastal Local Area Bank Ltd.
Corporation Bank
Dena Bank
Deutsche Bank AG
Development Credit Bank Ltd.
ICICI Bank
IDBI Bank Limited
Indian Bank
Indian Overseas Bank
IndusInd Bank Limited
Industrial Development Bank of India
ING Vysya Bank
J and K Bank
J P Morgan Chase Bank, National Association
Karnataka Bank
Karnataka State Co-operative Apex Bank
Karnataka Vikasa Gramina Bank
Karur Vysya Bank Limited.
Kaveri Grameena Bank
Kotak Mahindra Bank Limited
Krung Thai Bank Public Company Limited
Lord Krishna Bank Ltd.
Mashreqbank psc
Mizuho Corporate Bank Ltd.
Oman International Bank S A O G
Oriental Bank of Commerce
Pragathi Krishna Gramin Bank
Punjab & Sind Bank
Punjab National Bank
SBI Commercial and International Bank Ltd.
Societe Generale
Sonali Bank
Standard Chartered Bank
State Bank of Bikaner and Jaipur
State Bank of Hyderabad
State Bank of India
State Bank of Mauritius Ltd.
State Bank of Mysore
State Bank of Patiala
State Bank of Travancore
Syndicate Bank
Tamilnad Mercantile Bank Ltd.
The Bank of Nova Scotia
The Bank of Rajasthan Limited
The Bank of Tokyo-Mitsubishi, Ltd.
The Development Bank of Singapore Ltd. (DBS Bank Ltd.)
The Dhanalakshmi Bank Limited.
The Federal Bank Ltd.
The HDFC Bank Ltd.
The Hongkong & Shanghai Banking Corporation Ltd.
The Jammu & Kashmir Bank Ltd.
The Lakshmi Vilas Bank Ltd
The Nainital Bank Ltd.
The Ratnakar Bank Ltd.
The Royal Bank of Scotland N.V.
The Sangli Bank Ltd.
The Saraswat Co-Operative Bank
The South Indian Bank Ltd.
UCO Bank
Union Bank of India
United Bank Of India
Vijaya Bank
Yes Bank
Account No.
Branch IFSC
Qualifying Examination Details
Qualifying Exam
M.B.B.S.
College / Institute Name
Name of University/Board
Date of Passing
Exam Roll No
Max.Marks
Marks Secured
Percentage
Selection Details
Selection Quota
AIQ
State
Selection Round
Round-1
Round-2
Round-3
MOP Up
KEA Admission Order No (for SQ Only)
NEET Roll No
NEET Marks (for 800)
NEET %
A I Rank
State Rank
Reservation Claimed
GM-General Merit
SC-Scheduled Caste
ST-Scheduled Tribe
C1-Category-I
2A-Category-2A
2B-Category II B
3A-Category 3A
3B-Category III B
OBC
Reservation Allotted
GM-General Merit
SC-Scheduled Caste
ST-Scheduled Tribe
C1-Category-I
2A-Category-2A
2B-Category II B
3A-Category 3A
3B-Category III B
OBC
Hyderabad Karnataka Quota?
No
Yes
PH Quota?
No
Yes
Uploads
Student Photo (JPEG Only)
NEET PG Admit Card (PDF)
NEET PG Score Card (PDF)
SSLC/ Class-X Marks Card (PDF)
PUC / 12th Marks Card (PDF)
Transfer Certificate (If applicable) (PDF)
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I Hereby solemnly affirm that the statement made, information furnished and documents submitted by me along with this declaration are true & correct to the best of my knowledge. If any information furnished therein is found to be fraudulent, incorrect or untrue, I am liable for prosecution and cancellation of my admission.
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