Provisional Registration
Registration No :		Registration Date :
First Name :	*	Middle Name :
Last Name :	*	Father Name :	*
Date Of Birth :	*	Gender :	Transgender Male Female
Residential Address
Address :	*	City/Town/Village :	*
Post :		Block/Tehsil :
State :	Madhya Pradesh *	District :	Select Alirajpur Anuppur Ashoknagar Balaghat Barwani Betul Bhind Bhopal Burhanpur Chhatarpur Chhindwara Damoh Datia Dewas Dhar Dindori Guna Gwalior Harda Hoshangabad Indore Jabalpur Jhabua Katni Khandwa Khargone Mandla Mandsaur Morena Narsinghpur Neemuch Panna Raisen Rajgarh Ratlam Rewa Sagar Satna Sehore Seoni Shahdol Shajapur Sheopur Shivpuri Sidhi Singrauli Tikamgarh Ujjain Umaria Vidisha Agarmalwa Agar *
Pin Code :	*
Permanent Address
Same as Residential Address
Address :	*	City/Town/Village :	*
Post :		Block/Tehsil :
State :	Select Andaman and Nicobar Island Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Dadra and Nagar Haveli Daman and Diu Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Lakshadweep Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Puducherry Punjab Rajasthan Sikkim State Tamil Nadu Telangana Tripura Uttar Pradesh Uttarakhand West Bengal *	District :	*
Pin Code :	*
Preferred Address :	Select Residential Permanent *	Mobile No. :	1.  *     2.
Email Id :	* Please Enter Valid Email ID	Preferred Mobile No. :	Mobile No. 1 Mobile No. 2
Qualification
Roll No :	*	University Enrollment No :	*
Degree Name Name of University Name of College Passing Year B.V.SC.& A.H. Select Sri Venkateswara Veterinary University , Tirupati A.P Agricultural University Osmania University Acharya N.G. Ranga Agriculture University Assam Agricultural University, Jorhat Guwahati University Rajendra Agriculture University,samastipur Birsa Agriculture University,Ranchi Bihar Agriculture University,Bhagalpur Chhattisgarh Kamdhenu Vishwavidyalaya, Anjora, Durg Indra Gandhi Krishi Vishwa Vidhyalaya,Raipur Anand Agricultural University, Anand Sardarkrushinagar Dantiwada Agricultural University, Sardarkrushinagar Navsari Agricultural University, Navsari Junagadh Agricultural University, Junagadh Sardar Patel University Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar Haryana Agriculture University,Hissar CSK Himachal Pradesh Krishi Vishwavidyalay, Palampur Sher-e Kashmir University of Agricultural Sciences & Technology, Jammu Birsa Agricultural University, Ranchi Karnataka Veterinary, Animal & Fisheries Sciences University, Bidar University of Mysore University of Agriculture Science Dharwad Kerala Veterinary and Animal Science University, Pookot University of Calicut University of Kerala Kerala Agriculture University Nanaji Deshmukh University of Veterinary Sciences, Jabalpur University of Jabalpur Madhya Pradesh pashu chikitsa Vigyan Vishwavidhyalaya,Jabalpur J.N.K.V.V jabalpur Central Agricultural University manipur Maharashtra Animal & Fishery Sciences University, Nagpur Konkan Krishi Vidhya peeth Maharashtra Agriculture University Mahatma Phule Krishi Vidhyapeeth,Pune Marathwada Krishi Vidhyapeeth,Parbhani Nagpur University,Nagpur Dr BSSkrishi Vidhyapeeth Dhapoli PanjabRao Deshmukh Krishi vidhyapeeth,Akola Central Agricultural University, Imphal Orissa University of Agriculture  & Technology, Bhubaneswar  Pondicherry University, Puducherry Guru Angad Dev Veterinary and Animal Sciences University Punjab Agriculture University,Ludhiyana Rajasthan University of Veterinary & Animal Sciences, Bikaner Rajasthan Agriculture University,Bikaner University of Rajasthan Udaipur University Swamy keshwanand university of veterinary & Animal Sciences,Bikaner Tamil Nadu Veterinary & Animal Sciences University, Chennai University of Madras Tamilnadu Agriculture University Narendra Deva University of Agriculture & Technology, Faizabad Uttar Pradesh Pandit Deen Dayal  Upadhyay Pashu Chikitsa Vigyan Vishwavidyalay Evam  Go- Anusandhan, Mathura Chandra Shekhar Azad University of Agriculture & Technology ,Kanpur Magadh University Govind Ballabh Pant University of Agriculture  & Technology,  Pantnagar West Bengal University of Animal & Fishery  Sciences, Kolkata Bidhan Chandra Krishi Vishwa Vidhyalaya Tripura University, Agartala Other University National Dairy Research Institute,Karnal,Haryana Indian Veterinary Research Institute,Izzat nagar Bareili * Select College of Veterinary Science & Animal Husbandry, Jabalpur College of Veterinary Science & Animal Husbandry, Mhow College of Veterinary Science & Animal Husbandry, Rewa * 2024-2025
Note: Please upload photo which will be used for official purpose , file size should not be greater than 1024 kb and file format should be jpeg,png,jpg,gif *
University/ Course completion certificate:	*	Photo:	*
Others :
Payment Type :	Online Payment Offline Payment	Payable Amount :
Payment
Cheque/DD No :	*	Bank Name	*
Payment Date :	*