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Sheikh Fazilatunnessa Mujib Memorial KPJ Nursing College

Apply Online Admission

Choice Program

Program : *

Personal Information

Student Name : *

Student Name in Bengali : *

Student Religion : *

Student Nationality : *

Student Date of Birth : *

Student Blood Group : *

Student NID/Birth Certificate No : *

Father's Name : *

Father's Name in Bengali : *

Father's Profession : *

Mother's Name : *

Mother's Name in Bengali : *

Mother's Profession : *

Contact Number Self : *

Contact Number Father/Mothers : *

Contact Number Others : *

Local Guardian Name : *

Relation with Student : *

Local Guardian Profession : *

Local Guardian Contact No : *

Student Photo : * Max 1 Mb.Only JPG & PNG Allow

Local Guardian Photo : * Max 1 Mb.Only JPG & PNG Allow

Present Address

Division : *

District : *

Thana : *

Post Office : *

Post Code : *

Village : *

Permanent Address

Division : *

District : *

Thana : *

Post Office : *

Post Code : *

Village *

Academic Qualification

Education Level: Secondary

Name of Exmination : *

Year of Passing : *

Reg. No : *

Roll. No : *

Education Board : *

GPA With 4^th Subject : *

GPA Without 4^th Subject : *

Name Of Institution : *