Board of Ayurvedic and Unani Tibbi Systems of Medicine, U.P.

7 Lal Bagh, Dhanvantri Bhavan, Lucknow-226001

Application for Registration of Ayurvedic and Unani Doctors

Applicant Id : 10234509 Form Filled On : 19/07/2023

Name : DR. ASJAD RAZA

Father Name : ARSHAD ALI

Date of Birth : 17/02/1998

Mobile No. : 8791736154

Email Id : razaasjad818@gmail.com

Permanent Address : HOUSE NUMBER 240 K, EID GAH GALI NUMBER 3B, MORADABAD, MORADABAD,
UTTAR PRADESH, INDIA - 244001
Place of Practice : HOUSE NUMBER 240 K, EID GAH GALI NUMBER 3B, MORADABAD, MORADABAD,
UTTAR PRADESH, INDIA - 244001

Academic/ Professional Qualification

Examination School /College Attended Board/ University Admission Passing Roll No. Enrollment
Year Year No.

HIGH SCHOOL/ K CHANDRA B V M H S BOARD OF HIGH 2013 2013 1134410

EQUIVALENT SCHOOL SCHOOL AND
INTERMEDIATRE
EDUCATION U.P
INTERMEDIATE/ HEWETT MUSLIM INTER BOARD OF HIGH 2015 2015 0550085
EQUIVALENT COLLEGE MORADABAD SCHOOL AND
INTERMEDIATRE
EDUCATION U.P
B.U.M.S TIPU SULTAN UNANI RAJIV GANDHI 2016 2021 16U0206
MEDICAL COLLEGE & UNIVERSITY OF
HOSPITAL HEALTH
SCIENCES,
BANGALORE

Declaration
I, DR. ASJAD RAZA, son/ daughter/ wife of ARSHAD ALI hereby declare that all the statement and entries made in the application are
true , complete and correct to the best of my knowledge and belief. In the event of any information being found false or incorrect or
ineligibility being detected, my registration may be cancelled by the Board of Ayurvedic and Unani Tibbi Systems of Medicine U.P.

Date : ................................................................... Signature of Applicant: ..............................................................

List of Documents Uploaded :

This is a software generated report Printed On : 19/07/2023

 1 Aadhaar
: Card
2 Photocopy
: of High School Marksheet
3 Photocopy
: of High School Certificate
4 Photocopy
: of Intermediate Marksheet
5 Photocopy
: of Intermediate Certificate
6 Photocopy
: of B.A.M.S / B.U.M.S 1st Year Marksheet
7 Photocopy
: of B.A.M.S / B.U.M.S 2nd Year Marksheet
8 Photocopy
: of B.A.M.S / B.U.M.S 3rd Year Marksheet
9 Photocopy
: of B.A.M.S / B.U.M.S 4th Year Marksheet
10 Photocopy
: of B.A.M.S / B.U.M.S 5th Year Marksheet
11 Photocopy
: of B.A.M.S/ B.U.M.S Certificate
12 Photocopy
: of B.A.M.S/ B.U.M.S Internship Certificate
13 Photocopy
: of B.A.M.S/ B.U.M.S Hospital Internship Certificate
14 Photocopy
: of Provisional Degree/ Degree
15 Payment
: Receipt
16 Aadhaar
: Card - 850653478315

Note :- Print out of this form along with the bank draft for the verification fee as per your university from below list (Only for
universities mentioned below) needs to be sent to "Registrar, Board of Ayurvedic and Unani Tibbi Systems of
Medicine U.P., 7 Lal Bagh, Dhanvantri Bhavan, Lucknow-226001" by registered post/ speed post.

This is a software generated report Printed On : 19/07/2023

This is a software generated report Printed On : 19/07/2023
This is a software generated report Printed On : 19/07/2023
Except Rajiv Gandhi University, following Universities/Institutions have to attach bankdraft of B.A.M.S./B.U.M.S.
passed graduation examination result verification fees along with registration application form :

S. No. University/ Institution Amount In favour of

1 University of jammu, jammu 1770 Registrar, University of jammu or deposit the same
through online portal www.coeju.com
2 Utkal University Bhubaneswar 1000.00 Controller of Finance, Utkal University, Vani Vihar,
Bhubaneswar
3 Awadhesh Pratap Singh University, Reeva 200.00 Registrar, Awadhesh Pratap Singh University,
Reeva (M.P.)
4 The Tamilnadu Dr. M.G.R. Medical University, 400 Registrar, Tamilnadu Dr. M.G.R. Medical University
CHENNAI CHENNAI
5 Gulbarga University 1000.00 Finance Officer, Gulbarga University

6 Gujarat Ayurved University 400 Registrar, Gujarat Ayurved University, Jamanagar

7 Jiwaji University GWALIOR 200.00 Registrar, jiwaji University GWALIOR

8 Rajasthan University Jaipur 170.00 Registrar, University of Rajasthan, Jaipur

9 PT. Ravishankar Shukla University Raypur 1000 Registrar, PT. Ravishankar Shukla University
(C.G.) Raypur (C.G.)
10 University of MUMBAI 1500.00 "The Finance & Account Officer" University of
MUMBAI
11 savitribai phule pune university (University of 180.00 for Pay by chalan only..The challan form is available on
Pune) degree and university website-- www.unipune.ac.in If any trouble
180 for contect university helpnine number.
marksheet
verification
12 Punjab University CHANDIGARH 500.00 Registrar, Punjab University CHANDIGARH

13 University of DELHI 500.00/1000.0 The Director, University of Delhi South Campus(upto

0 6 Years Rs 500/more than 6 Years Rs1000) Pay
online- misconlinefee.du.ac.in Under miscellaneous
fee- verification of marksheet
14 Rajib Gandhi Memorial Ayurvedic College & 200.00 Principal Superintendent,Rajib Gandhi Memorial
Hospital Dist-24 Parganas (N) Ayurvedic College & Hospital Dist-24 Parganas (N)
15 University of Calcutta 1000.00 University of Calcutta

16 Rani Durgavati University, Jabalpur 100.00 Registrar, Rani Durgavati University, Jabalpur

17 Maharashtra University of Health Sciences 2600 Registrar Maharashtra University of Health

Nashik Sciences Nashik
18 Baba Farid University of Health Sciences 500.00 Registrar,Baba Farid University of Health Sciences
Faridkot Faridkot
19 Rajiv Gandhi University of Health Sciences, 1000.00 Pay online university website-www.rguhs.ac.in
Banglore
20 Himanchal Pradesh University Shimla 1000.00 Controller/Registrar, Himanchal Pradesh University
Shimla
21 Dr.HariSingh Gour Vishwavidhalaya, Sagar- 1000.00 State Bank of India (SBI) A/C NO. 32000156472
470003 (M.P.) India power jyoti bank
22 Barakatullah University Bhopal 600 Registrar, Barakatullah University Bhopal

23 Vinoba Bhave University Hazaribag 1000.00 Registrar, Vinoba Bhave University Hazaribag
(Payable by Bank Draft / Bank Challan)
This is a software generated report Printed On : 19/07/2023
24 Pt. Deendayal Upadhyay Memorial Health 700.00 Registrar, Pt. Deendayal Upadhyay Memorial
Sciences and Ayush University of Chhattisgarh Health Sciences and Ayush University of
Chhattisgarh
25 Kurukshetra University, Kurukshetra 450 Registrar, Kurukshetra University, Kurukshetra

26 Chhatrapati Shahuji Maharaj University, Kanpur 300 financ officer, C.S.J.M university through R.T.G.S /
NEFT a/c no- 349502050000603 I.F.S.C code-
UBINO534951
27 shivaji university, kolhapur, maharashtra 530 finance & A/C officer shivaji university, kolhapur

28 Hemwati Nandan Bahuguna Gharwal University, 500 Registrar, Hemwati Nandan Bahuguna Gharwal
Uttarakhabd University, Uttarakhabd
29 Acharya nagarjun University, Andhra pradesh 820.00 Registrar, Acharya nagarjun University, Andhra
pradesh
30 Kuvempu University, karnataka 1330 Finance Officer, Kuvempu University, jnana
sahyadri, shankaraghatta
31 Dr NTR University Of Health Sciences, 6000.00 Registrar, Dr NTR University Of Health Sciences,
vijayawada Vijayawada
32 Kakatiya University, Warangal, Twlangana 500.00 Through Online In favour of ‘’The Registrar, KU,
Examination Account” (A/C No.52026910298; IFSC
Code: SBINOO20262)
33 Karnataka University, karnataka 620.00 The process of E-payment by logging to SBI portals
or by transferring of amount though the process of
direct transfer to the saving Bank(Karnataka
University, Campus, Dharwad) A/c No mentioned
below in the name of Finance Officer, Karnataka
University, Dharwad 01- State Bank Of India-
11605350447 (IFSC: SBIN0001728), 02-
Syndicate Bank- 12063050000017(IFSC:
SYNB0001206)
34 Sambalpur University, Sambalpur, odisa 1000.00 Controller Of Finance Sambalpur University

35 Uttarakhand Technical University, Dehradun 500.00 FC, Uttarakhand Technical University, Dehradun

36 GURU NANAK DEV UNIVERSITY, AMRITSAR 1186 PAY ONLINE AT UNIVERSITY WEB SITE-
http://www.gndu.ac.in/certificate/php_users
37 NAGPUR UNIVERSITY, NAGPUR 200 Finance & account Officer R.T.M.N.U

38 University of calicut 2535.00 01- draft (The finance officer university of culicut)
02- online ( through the link University of Calicut |
E-payment and the chalan receipt should be
forwarded to the board)
39 Panjabi University, Patiala 2160.00 Registrar, Panjabi University, Patiala, payable at
Patiala
40 the west bengal university of health sciences, 1000 "The west bengal university of health science"
kolkata Payable at kolkata
41 Uttarakhand Ayurveda University, Dehradun 600.00 Finance Officer, Uttarakhand Ayurved University,
Dehradun
42 Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved 1000.00 'Registrar, Dr S.R. Raj. Ayurved University,
University, Jodhpur Jodhpur"Payable at jodhpur
43 osmania university, Hyderabad, Telangana 500.00 The Registrar, Examination fee fund Account,
Osmania University, hyderabad (payable at
hyderabad)
44 lucknow university lucknow (only for MD/MS 2000.00 PAY ONLINE AT UNIVERSITY WEB SITE-
doctors) https://www.lkouniv.ac.in or bank draft- finance
officer, lucknow university, lucknow

This is a software generated report Printed On : 19/07/2023