HOMEPAGE

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.

HOMEPAGE OVERVIEW

INSTRUCTION PAGE

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

PAGE REVIEW

Click Here after

reading information

displayed

PAGE PREVIEW

Please check the

particulars

shown in red

once again

before final

submission.

These

particulars are

not editable

once submitted.

CONFIRM MESSAGE

Click here for Final Submission

Click here for Edit in

Application form

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

STEP 2 - COMPLETION PAGE

SELECT MODE OF PAYMENT

Please select any one mode

for payment.

PAYMENT THROUGH E-CHALLAN

THROUGH SYNDICATE/ CANARA BANK / POST OFFICE

SYNDICATE BANK E-CHALLAN PAGE

INDIA POST CHALLAN PAGE

CANARA BANK CHALLAN PAGE

UPDATE E-CHALLAN DETAILS AFTER DEPOSIT OF PAYMENT IN BANK OR POST OFFICE

UPDATE TRANSACTION DETAILS OF E-CHALLAN

STEP 3 - COMPLETION PAGE

CONFIRMATION PAGE GENERATED AFTER PAYMENT OF FEE THROUGH E_CHALLAN

OR PAYMENT THROUGH ANY CREDIT/DEBIT CARD

SAMPLE PAGE FOR PAYMENT THROUGH CREDIT/DEBIT CARD

CONFIRM PAYMENT PAGE

PAYMENT GATEWAY PAGE

ENTER DETAILS OF THE DEBIT/CREDIT CARD

ENTER SECUTRE CODE/PASSWORD FOR CONFIRM PAYMENT

STEP 3 - COMPLETION PAGE

CONFIRMATION PAGE GENERATED AFTER PAYMENT OF FEE THROUGH CREDIT/DEBIT CARD

ADDRESS SLIP