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Emailing Thesis Protocol Submission Form - 2015

This document provides instructions for submitting a thesis protocol for DNB candidates. It outlines the required enclosures, including a properly filled submission form, the thesis protocol signed, and approval from the institutional ethical committee. Candidates have 90 days from the start of their training to submit their protocol. The document also provides contact information for inquiries about thesis protocols and notes that name, subject, registration number and submission date should be included in any correspondence.

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Akbar Pattupara
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263 views4 pages

Emailing Thesis Protocol Submission Form - 2015

This document provides instructions for submitting a thesis protocol for DNB candidates. It outlines the required enclosures, including a properly filled submission form, the thesis protocol signed, and approval from the institutional ethical committee. Candidates have 90 days from the start of their training to submit their protocol. The document also provides contact information for inquiries about thesis protocols and notes that name, subject, registration number and submission date should be included in any correspondence.

Uploaded by

Akbar Pattupara
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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THESIS PROTOCOL SUBMISISON FORM

 General Instructions:
 Incomplete submission forms will not be considered.
 Use Black/Blue Ball pen only to fill up the form.

 Enclosures to be submitted along with protocol submission form:


 Form for Thesis Protocol Submission properly filled.
 Thesis Protocol duly signed.
 Approval letter of institutional Ethical committee.
(Mandatory, non receivable of any one is liable for rejection)

 DNB candidates are required to submit their thesis protocol within 90 days of their joining
DNB training.

 Any change in your correspondence address after submission of thesis Protocol should
be intimated to NBE at email [email protected] , [email protected] so as to
affect timely dispatch of communications.

 For inquiries pertaining to thesis protocol, you may write to [email protected]

 Mention your Name, Subject, Registration No. and Date of submission of thesis protocol
in any correspondence pertaining to thesis protocol.

Thesis Protocol Submission Form and Format for Protocol Page 1 of 4


THESIS PROTOCOL SUBMISISON FORM

A. GENERAL INFORMATION

1. Name (in full) : Paste here


(Do not pin or staple)
………………………………………………………………………………………………..

2. Father’s/Husband’s Name : A recent passport size


photograph.

…………………………………………………………………………………………………………..

3. Correspondence Address :
………………………………………………………………………………………………………………
…………………………………………….…………………………………………………………………
………………………………………………………………………………………….……………………
………………………………………………
Telephone No…………………………………………..Mobile
………………………………………………..

4. Permanent Address:
………………………………………………………………………………………………………………
…………………………………………….…………………………………………………………………
………………………………………………………………….……………………………………………
………………………………………………
Telephone No…………………………………………..Mobile
………………………………………………..
E-mail
………………………………………………………………………………………………………………
…….

B. DNB TRAINING DETAILS

5. Registration Details
a) Reg.No.
…………………….…………………………………………………………………………………..
b) Date of Registration
…..………………………………………………………………………………….
c) Scheduled Date of Completion of DNB training ……………………………………………..

Subject
Institute/ University
State
Period of Training

Thesis Protocol Submission Form and Format for Protocol Page 2 of 4


Correspondence Address of the Institute :

d) Information about Thesis Protocol

Title

Area of Specialty
(Medicine, surgery
etc)
Faculty Name and Designation Qualification Primary place of
Practice

Thesis Guide

Co-guides (if any)

Thesis Protocol Submission Form and Format for Protocol Page 3 of 4


C. FORMAT FOR PROTOCOL SUBMISSION
(Protocol to be attached here as per the given format)

1.1 Introduction:

1.2 Review of Literature:

1.3 Aims & Objectives:

1.4 Material & Methods:

1.5 References:

1.6 Study Proforma:

1.7 Approval of Ethical Committee & its Composition:

1.8 Approval of Scientific Committee & its composition:

Signature of the candidate Signature of HOD

(Forwarded through approved channels) (MANDATORY)

Signature of Thesis Guide/Co-Guide Signature and stamp of Head of Institution

(MANDATORY) (MANDATORY)

Thesis Protocol Submission Form and Format for Protocol Page 4 of 4

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