Name * Father's Name * Nationality * Indian Non Indian Category * General OBC SC/ST Caste Is Physically Handicapped? * Yes No Permanent Address * State * Contact No. * Aadhar No. * Mother's Name * Religion * Hindu Muslim Sikh Christan Others Religion Gender * Male Female D.O.B. * City * Pin Code * Rural/urban * Parent's Contact No. * Educational Details : Qualification * Qualification * Qualification* Subject * Subject * Subject * Passing Year * Passing Year * Passing Year* Percentage * Percentage * Percentage * Board * Board * Board * Total * Total * Total * Declaration : 1 . I shall obey the Rules & Regulations of the Institute and the Institute Mess. 2. I shall not take part in any subversive activities including ragging in any form in the Institute Campus or the Institute Mess or anywhere at Durgapur or outside anytime during my stay at the Institute. 3. If I involve myself in any type of subversive activities, the Institute Authority alone or in consultation with local Administration may take any type of disciplinary action as per prevailing Rules & Regulations of the College. 4. I also agree to pay College Installment / Hostel fees in time. If I fail to pay the Hostel fees / Installment for consistently two months / two Installments I shall be liable to be struck off from the College roll. 5. All the information furnished here are true to the best of my knowledge and belief. I agree with terms & condition. * Yes Course Applied * A.N.M G.N.M B.SC Nursing Admission Year * Migration Dates * Migration Certificate Number * College Roll No * Session * Documents to be Submitted: 10th Mark Sheet * Migration Certificate(intermediate) * Physically Handicap Certificate Upload signature Certificate 12th Marksheet * 12th certificate * Upload Photo * Caste Certificate *