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Name*
Father's Name*
Mother's Name*
Gender
Date of Birth*
Aadhar Card Number
Contact No.*
E-mail
Nationality*
Cast*
Parent's Occupation
Parent's Income
10th Board Name*
Name of Institution
Registration No.*
Total Marks
Marks Obtained
Percentage*
+2 Board Name*
Name of Institution
Registration No.*
Total Marks
Marks Obtained
Percentage*
Name of Subjects
Other Education after +2
Address for correspondence
Choose Course*
B. Sc. Nursing (4 years)
Post Basic B. Sc. Nursing (2 years)
G.N.M.
A.N.M.
Bachelor of Physiotherapy
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I hereby declare that the information furnished above is true, complete and correct and I understand that false or fraudulent statements within this application can result in my cancellation of admission in this institution
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