Registration form for JIPMER MBBS Entrance Examination 2019

Please enter Applicant's Name.
Note: The details should correspond to entry in any standard document issued by Government/School/College/University.
Select Date of Birth.
Note: The date of birth should correspond to the entry in 10th Standard Mark sheet/Certificate.
Please enter Mobile No..
Please Re-Enter Mobile No..
Please enter Email ID.
Please Re-Enter Email ID.
Version 13.06.01