DMWIMS DM WAYANAD INSTITUTE OF MEDICAL SCIENCES
ENQUIRY
 
CANDIDATE DETAILS
1 Name of the Candidate *
Gender * Marital Status * Date of Birth * Place of Birth
Pick Date
Mother Tongue Religion Cast Community
Phone No * Email ID * Category applying for Nationality *
PARENT'S DETAILS
2  Father's Name/Occupation Father's Name * Occupation Annual Income
Mother's Name/Occupation Mother's Name Occupation
COMMUNICATION DETAILS
3 Address 1 * Address 2 *
City State Country Zip code
DETAILS OF QUALIFYING EXAMINATION
4
Board of examination Month & Year of Passing Institute last studied with location
Subject Maximum Marks Marks Secured * % of marks
English
Physics
Chemistry
Biology
Total Marks
5 Remarks / Notes
6 Enter the text as shown in picture *