Registration for JIPMER D.M. / M.Ch. Entrance Examination - January 2018 Session
 
Note: 1. Fields marked with * are mandatory.
2. Fill in the details and click on Register to proceed.
3. Kindly use Internet Explorer(version 10 to 11) or Mozilla Firefox(48 to 54) or Google Chrome(50 to 59) to fill in the Registration Form.
4. After successful registration you will receive User ID and Password to the registered Mobile number and Email ID.
5. Please read the Prospectus carefully before filling this Registration.
6. Login link will be sent to the registered Email ID.
7. Click on the login link to fill the application.
Personal Details
Note: The details should correspond to entry in any standard document issued by Government/School/College/University.
*Name of the Applicant (First Name) (Middle Name) (Last Name/Initial)
*Date of Birth (dd/mm/yyyy)
*Mobile Number
*Confirm Mobile Number
*Email Id
*Confirm Email Id

Please enter the letters displayed in the image below.
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