Please read the instructions carefully before filling in the form with all relevant details in BLOCK LETTERS only

COURSE APPLIED FOR:

Full name of the applicant(Student):

Father’s/Husband’s Name:

Mother’s Name:

Date of Birth:

Gender:MaleFemale

Nationality:

Religion:

Category:GeneralSCSTOBCOthers

Mobile No:

Email-id:

Address for communication:(Bye-lane/Path/H.No:,Vill,PO,PS,District,Pin,State.)

Qualification:

Percentage:%

10th & 12th Scan Copies of Admit, Marksheet & Pass Certificate,Photograph- Copies Student & 1 Copy Parents,Caste Certificate,PRC,Voter ID/PAN Card

10th Scan Copy of Admit Card:

10th Scan Copy of Marksheet:

10th Scan Copy of Pass Certificate:

12th Scan Copy of Admit Card:

12th Scan Copy of Marksheet:

12th Scan Copy of Pass Certificate:

Applicant(Student)Photograph:

Parents Photograph:

Caste Certificate:

PRC:

Voter ID/PAN Card:


Only For Post Basic B. Sc. (Nursing)

GNM Marksheet:

GNM Certificate:


Only for Master of Science in Nursing (M. Sc. Nursing)

B.Sc(N) Marksheet:

B.Sc(N) Certificate:


Only for MPT

BPT Marksheet:

BPT Certificate:

SUBMIT YOUR APPLICATION FORM