Admission Formadmin2019-11-29T09:30:52+00:00 Name * Father's Name * Guardian's Name Date of Birth * Phone No. * Course * —Please choose an option—B.Sc Nus.GNMMPHW(F)ANM Correspondence Address Permanent Address * Marital Status * —Please choose an option—SingleWidow/DivorcedMarried Any Working Experience Academic Qualifications (Starting form Matriculation Onwords) First Qualification S.r. no. Class University/Board Name of School/Collage Division & % Year of Passing Second Qualification Third Qualification Do you Belong to: Backward Class —Please choose an option—YesNo Schedule Class —Please choose an option—YesNo Schedule Tribe —Please choose an option—YesNo Passed Hindi/State Language upto Matriculation —Please choose an option—YesNo I hereby declare that the information given in this application is true and correct to the best of my knowledge and belief. In case any information given in this application proves to be false or incorrect, I shall be responsible for the consequences. I also declare that if any information provided by me is found false, my candidature may be rejected at any point of time.
