Price Rs.
50/-
BABA FARID UNIVERSITY OF HEALTH SCIENCES
APPLICATION FORM FOR MERCY CHANCE
FEE: Rs 15000/- + Exam Fee
1. Name: ________________________________
2. Father’s Name: ________________________________
3. Registration No: ________________________________
4. College Name: ________________________________
5. Examination: ________________________________
6. Session/Year: ________________________________
7. Reason for Mercy Chance: ________________________________
(documents attached)
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8. Total number of chances already availed, Give detail as asked below:
Availed Roll No Year Session Result
chances
1st
2nd
3rd
4th
5th
6th
Note: wef 2007 Admission Year, Max. chances allowed as follows:
*BPT ** BSc (MLT)
B.Sc. (Med. Anat, Phy, BCH) : 6 chances
* (w.e.f. Adm. Year 2008, 4 chances) ** (w.e.f. Adm. Year 2009: 4 chances)
MBBS,BDS,B.Pharmacy, B.Sc. (Nursing) : 4 chances
B.Sc. (Post Basic Nursing) : 3 chances
9. Bank draft/University Receipt no. __________Date: ________ Amount _______
(Bank Draft should be drawn in favour of Registrar, BFUHS, payable at Faridkot)
10. Full Address of the Applicant ______________________________
__________________________________________________________________
_________________________________________________________________
11. Contact No./Mobile No. ______________________________
12. e-mail address ______________________________
Full Signatures of the Applicant
Date:_________
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CERTIFICATE
It is recommended that the applicant _________________________son/daughter
of ________________________ may be allowed Mercy Chance to appear in the
examination as stated above under the Ordinances/Regulations in force on the
prescribed fee.
Principal
Date:_______ (Signature with Official stamp)
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(FOR OFFICE USE ONLY)
Remarks Regarding Case:
______________________________________________________________________________
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