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Student Registration Panel ( Hygienists / Mechanics / DORA Registration )
**NOTE - PLEASE DO NOT USE MOBILE OR LAPTOP FOR SCANNING THE DOCUMENTS**
Candidate Details
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Registration Part in Name
A
Title
--Select--
SRI.
SMT.
KM.
*
First Name
Middle Name
Last Name
*
Father's Name
Gender
Male
Female
*
Mother's Name
*
Religion
--Select--
Hindu
Muslim
Sikh
Christian
NA
*
Permanent Address
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Date Of Birth
*
Country
India
*
State
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*
District
--Select--
*
Pincode
*
Mobile No
*
Aadhaar No
*
Email-ID
Course Details
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Course
--Select--
DENTAL HYGIENISTS
DENTAL MECHANICS
DORA
*
Are you passed from U.P. College ?
YES
NO
*
College
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*
Year of Joining
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January
February
March
April
May
June
July
August
September
October
November
December
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Examination Held
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January
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I here certify that the information furnished in this application is true to the best of my knowledge and belief. My Application/Registration may be rejected/cancelled, if any information provided herein is found to be incorrect or fake at any time during or after the submission of form. I understand that the U.P. DENTAL COUNCIL is not responsible for any inadvertent error that may have crept in the application being filled online over the internet.
मैं एतद्द्वारा प्रमाणित करता / करती हूँ की इस आवेदन में दी गयी समस्त जानकारी मेरे ज्ञान और विश्वाश के अनुसार सही है | किसी भी समय अगर गलत सूचना पायी जाती है तो मेरा आवेदन/रजिस्ट्रेशन निरस्त कर दिया जाये | मैं समझता / समझती हूँ की उ० प्र० डेंटल कौंसिल किसी भी अनजान त्रुटि के लिए जिम्मेदार नहीं है जो इंटरनेट पर ऑनलाइन भरे जाने वाले आवेदन में शामिल हो सकती हैं |
