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To familiarise Candidates with the Online Application Form of AIPMT - 2014, Replica of Application form and important instructions are given below. Candidates are advised to go through the Information Bulletin carefully and download Replica of Application Form to acquaint themselves with all requirements to submit Application Online.
APPLICATION FORM
Choose any one
either India or OCI
State to which the
Applicant belong
i. 1. Students from AP and J&K
are not eligible for 15% All
India Quota (Rule 9.1 (iii) of
Information Bulletin.
ii. 2. Students from AP and J&K
who are domicile of other
States required to submit
Affidavit for 15% All India
Quota seats. (Appendix II of
Information Bulletin)
iii. 3. Candidate’s option for State
Quota seats will be generated
on the basis of State Code of
eligibility filled in here.
iv. 4. If Candidate’s State of
Parental Origin and State of
Domicile is different, Choose
State of parental origin.
i. Candidate’s option for State
Quota seats will be
generated on the basis of
State Code of Eligibility
filled in here.
ii. Candidate’s option for State
Quota seats will be
generated on the basis of
State Code of Eligibility filled
in here.
STATE CODE OF ELIGIBILITY AND
DOMICILE
Description
List of State Codes is at Appendix – IV of
Information Bulletin. For 15% All India Quota seats,
candidates may choose State Code(s) on the basis
of State to which the applicant belongs.
Candidate’s rank in the merit list for seats under
the control of participating States will be generated
on the basis of the State Code of Eligibility filled in
by the Candidates in the application form.
Guidelines and Rules regarding Domicile framed
by each participating State/University/Institution
shall be applicable in respect of the seats under
their control.
Candidates who are eligible for State Quota
seats in participating States/UT ( Appendix – IV of
Information Bulletin) may fill State Code
( Appendix – IV of Information Bulletin) of the
concerned State after ensuring his/her eligibility
as per criteria prescribed by the participating State.
Note: Candidate data regarding State of Parental
Origin, State of Domicile and State of Class XIIth
Study are captured in the Application form,
however candidate eligibility for seat shall be
subject to rules of the State/University/Institutions
concerned.
iii. Select Choice of
Examination Centre
Please check the
particulars
shown in red
once again
before final
submission.
These
particulars are
not editable
once submitted.
STEP 1 - COMPLETION PAGE
CHOOSE PHOTO & SIGNATURE FOR UPLOADING
Click here for uploading
your photograph and
signature
Click here for choosing
your image file of
photograph
Click here for choosing
your signature file
Please note down your Registration Number for
reference and for further use
UPLOAD PHOTO & SIGNATURE
Click here to upload your Photo
& Signature
Preview of your
photo and
Signature after
choosing image
files
PAYMENT THROUGH E-CHALLAN
THROUGH SYNDICATE/ CANARA BANK / POST OFFICE
SYNDICATE BANK E-CHALLAN PAGE
INDIA POST CHALLAN PAGE