Studentnotice 1349953350

Download as pdf or txt
Download as pdf or txt
You are on page 1of 4

AFFIDAVIT BY THE PARENT

(On Rs 10/- STAMP PAPER DULY NOTARISED)

I, _________________________________________________________________________
S/o, D/o of Mr./Mrs___________________________________________________________
Resident of _________________________________________________________________
Do hereby solemnly affirm and declare as under:
1. That my son/daughter Mr./Ms._______________________________ is a student of
MBBS at All India Institute of Medical Sciences (AIIMS) Bhubaneswar.
2. That I have gone through and fully understood the AIIMS Regulation/Directive for
Banning. Ragging and Anti-Ragging Measures in accordance with the AIIMS
Bhubaneswar office order on curbing the menace of Ragging to be followed by all
the students in AIIMS.
3. I assure you that my son/daughter/ward will not be involved or indulge in any act of
ragging that may come under the definition of ragging.
4. I have fully understood that in case my son/daughter/ward will be found indulging or
involved in Ragging within or outside the premises of the AIIMS, he/she shall be
appropriately punished for which he/she shall be solely responsible. I or my
son/daughter shall not hold liable the AIIMS or any of its officials for any loss (s)
damage(s) and shall not claim any compensation from the it’s or its office bearers.

Deponent

Signature of Parent/Guardian

VERIFICATION: verified at _______________ on this _________ day of _________ 2012.


That the above affidavit is true and correct.

Name : Address & Contact No : Deponent


Signature of Parent/Guardian
AFFIDAVIT BY THE STUDENT

(On Rs 10/- STAMP PAPER DULY NOTARISED)

I, _________________________________________________________________________
S/o, D/o of Mr./Mrs__________________________________________________________
Resident of _________________________________________________________________
Do hereby solemnly affirm and declare as under :
1. That I am joining as a student of MBBS at All India Institute of Medical Sciences
(AIIMS) Bhubaneswar.
2. That I have received and gone through and fully understood the AIIMS
Regulation/Directive for Banning, Ragging and Anti-Ragging Measures in accordance
with the AIIMS Bhubaneswar Office Order on curbing the menace of Ragging to be
followed by all the students of AIIMS.
3. I hereby solemnly affirm that :
• I will not indulge or involve myself in any behaviour or act that may come under
the definition of ragging.
• I will not participate in or abet or propagate ragging in any form.
• I will not hurt anyone physically or psychologically or cause any other harm.
4. I have fully understood that if found indulging or guilty of any aspect of ragging
within or outside AIIMS campus. I may be punished as per the provisions of the
AIIMS Regulations/Directive mentioned above and / or as per the law in force and
for which I will be solely responsible and shall not claim and compensation.

Deponent

Signature of Parent

VERIFICATION: verified at _______________ on this _________ day of _________ 2012.


That the above affidavit is true and correct.

Name : Address & Contact No : Deponent

Signature of Parent
UNDERTAKING

I, _________________________________________________________________________
S/o, D/o of Mr./Mrs___________________________________________________________
have passed MBBS Entrance Examination held on 1st June, 2012.

I certify that all my Original Certificates (i.e. 10th Passed/Age proof, 12th Passed
Marks Sheet and Certificate and Scheduled Caste/Scheduled Tribe (SC/ST)/Other Backward
Class (OBC) are authentic. If any found false, then my candidature may be treated
withdrawn/cancelled at any time during the course.

Name: ___________________________________

Signature of the candidate: ___________________

Address: __________________________________

_________________________________________

_________________________________________
DECLARATION BY THE CANDIDATE

I, __________________________________________________________________________
Son/daughter of Sh. __________________________________________________________
Village/Town/City ____________________________________________________________
District _____________________________________________________________________
State _________________________________________ Hereby declare that I belong to the
___________________________ community which is recognized as a backward class by the
Government of India for the purpose of reservation in service as per orders contained in
Department of Personnel and Training Office Memorandum No. 36012/2293. Estt. (SCT)
dated) 8.09.1993. It is also declared that I do not belong to persona/ section (Creamy Layer)
mentioned in column 3 of the Scheduled to the above referred Office Memorandum dated
08.09.1993.

Name: ___________________________________

Signature of the candidate: ___________________

Address: __________________________________

_________________________________________

____________________________________________

You might also like