Professional Documents
Culture Documents
Pin Code
Tel. No. .
For Office use only:
Amount Paid Rs. .
Amount deducted Rs. ..
Amount refunded Rs. ..
Cheque No. & date ..
Bank particulars ......
Enclosure : Photocopy of selection letter from another Competent Authority (if applicable)
Health Science
DMER, Mumbai ( 49 ) NEET UG-CET-2013 Brochure
Government of Maharashtra
Directorate of Medical Education and Research, Mumbai
NEET UG 2013 - Preference Form System
SCRUTI NY FORM
Candidate's Name : __________________________________________________________
Date of Birth : ________________ MHT-CET Roll No.: _______________ Category : ___________
Region Code : _________________
HSC PCB :
Signature of Candidate
(Arrange a set of original certificates and one set of attested photocopies separately in the order given below for verification)
Remarks : (For Office Use only)
Eligible : Yes / No
If not eligible, reason/s ____________________
Signature of Scrutiny Clerk
________________________________________
Any other remarks : ______________________
________________________________________
________________________________________
Name & Signature of Scrutiny Officer
Admit card of NEET UG 2013
NEET-UG 2013 Mark sheet
Nationality certificate/valid Indian passport
H.S.C. (or equivalent) examination marksheet
SSC (or equivalent) passing certificate
SSC (or equivalent) statement of marks
Medical fitness certificate (Annexure - I)
Bonafide certificate or Affidavit (for educational Gap)
If applicable
Caste Certificate
Caste Validity Certificate
Non Creamy layer Certificate valid upto 31/03/2014 (VJ, NT1,
NT2, NT3 & OBC including SBC)
Specified Reservation
D1/D2/D3 : Ex-servicemen Certificate, actual service certificate
D1/D2 : Domicile Certificate of Defence person
D3 : Transfer certificate
MKB : Dispute area cert., Mother tongue cert.
HA : Parent Domicile, SSC/HSC hilly area cert
Additional weightage claim certificate (if applicable)
S - 1
SML No.:
______/______
______/100
HSC E
APPLI CABLE FOR RESERVED CATEGORY CANDI DATES (EAR-MARKI NG) :
In pursuance of the "Ear-Marking Rule" (with reference to information brochure for
Preference system), I hereby exercise my option and opt for seat as and when I am
found entitled to admission on the basis of merit in an open category seat, as per my Preference
form.
Date : / / 2013 Signature of Candidate
-----------------
(Reserve/Open)