KYA-18 , Serial No:-.........

Khwaja Yunus Ali Medical College

Enayetpur, P.S:- Enayetpur, Chauhali, Sirajgonj-6751.
Tel: + 8802588834371-9, fax: +880 2588834431

Application Form For
Medical College Admission

General        Freedom Fighter
Fill all the information that are required to go next step

Freedom Fighter :

Personal Information :

Male    Female

Directorate General of Health Services (DGHS) :

Family Information :

Address :

Present/ Mailing Address *
Both Same
Permanent Address *

Name of Guardian :

Result of Previous Examination :

Examination Session * Passing Year * Grade * Total GPA *

Name of address of two referees resident in your country who could testify to your character, academic background and capacity of further studies.
(Preferable from head of schools / college)

Photo & Signature Upload :

* Admit Card or Roll No Slip of HSC/ A Level Examination Certificate

Payment Infomation :

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