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Admission Formats

The document appears to be a checklist for admission to nursing courses at a government college of nursing. It includes fields for student details and a list of required certificates for admission verification. The checklist is repeated for three students.

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Arathi Nair
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45 views4 pages

Admission Formats

The document appears to be a checklist for admission to nursing courses at a government college of nursing. It includes fields for student details and a list of required certificates for admission verification. The checklist is repeated for three students.

Uploaded by

Arathi Nair
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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GOVERNMENT COLLEGE OF NURSING

Medical College,Thiruvananthapuram.
Phone: 0471-2444290, 2551147
Fax: 0471-2551147 Email ID:[email protected]

B.Sc. Nursing/Post Basic B Sc Nursing/Post Basic Diploma in specialty Nursing/MSc Nursing


Check List
1 Name :
2 Date of Birth :
3 Application No. /Rank No. :
4 Course :
5 Category :

6 Certificates in Original (arrange the certificates in this order. Verification will be done in office)

Sl.No Certificates in Original Submitted Not Submitted


a. Allotment memo
b. Fee receipt
c. Certificate to prove Date of Birth
d. TC
e. Conduct Certificate
f. Mark list/ Pass Certificate (SSLC, AISSC/CBSE/ICSE (10 th )
g. Mark list/ Pass Certificate (PDC, /CBSE/ISC (12 th )
h. Mark list BSc Nursing/ GNM (if applicable)
i. Degree/diploma certificate (if applicable)
j. KNMC registration certificate (if applicable)
k. Eligibility Certificate
l. Migration Certificate
m. Caste Certificate (if applicable)
n. Income Certificate (if applicable)
o. Medical Fitness
p. Vaccination
q. Any other
7. Undertaking from Student/Parent - Anti ragging
8. Photographs (3 nos:)
9. Bond (if applicable)
10. Date of Admission

Tuition Fees Misc. Fees Caution Deposit Van Fees

Demand Draft No. : dated:

KUHS fees (if applicable) :

Clerk Sr. Superintendent Principal


GOVERNMENT COLLEGE OF NURSING
Medical College,Thiruvananthapuram.
Phone: 0471-2444290, 2551147
Fax: 0471-2551147 Email ID:[email protected]

ADMISSION CHIT

Name of Candidate :

Course to which admitted :

Date of Admission :

GOVERNMENT COLLEGE OF NURSING,


Medical College,Thiruvananthapuram
Phone: 0471-2444290, 2551147
Fax: 0471-2551147
Email ID:[email protected]

ADMISSION CHIT

Name of Candidate :

Course to which admitted :

Date of Admission :

GOVERNMENT COLLEGE OF NURSING,


Medical College,Thiruvananthapuram
Phone: 0471-2444290, 2551147
Fax: 0471-2551147
Email ID:[email protected]

ADMISSION CHIT

Name of Candidate :

Course to which admitted :

Date of Admission :
GOVERNMENT COLLEGE OF NURSING
Medical College,Thiruvananthapuram.
Phone: 0471-2444290, 2551147
Fax: 0471-2551147 Email ID:[email protected]

DECLARATION

I ---------------------------------------------------- admitted in --------------------------------------------------------


(course)will submit the following certificates within 5 DAYS

1.

2.

3.

4.

5.

Date…………… Signature of Students & Name


GOVERNMENT COLLEGE OF NURSING
Medical College,Thiruvananthapuram.
Phone: 0471-2444290, 2551147
Fax: 0471-2551147 Email ID:[email protected]

Admission to General Nursing & Midwifery Course


Check List

1 Name

2 Age & Date of Birth


Application No.
3
Rank No
4
Religion & Caste
5
SC/ST (Specify)
6
7 Certificates in Original (arrange the certificates in this order. Verification will be done in office)
7 Certificates in Original Submitted Not Submitted
a Allotment memo
b Fee receipt Rs- 15/-
c Certificate to prove Date of birth
d Transfer certificate
e Course &Conduct Certificate
f Mark list/ Pass Certificate (SSLC, AISSC/CBSE/ICSE (10 th)
h Mark list/ Pass Certificate (PDC/state/CBSE/ISC (12 th )
i Equivalence Certificate, If any
j Community Certificate
k Nativity Certificate
l Income Certificate
m Medical Fitness
Undertaking from
8 Student/Parent - Anti ragging
9 Photographs (3 nos)
10 Bond
11 Date of Admission

Clerk Sr. Superintendent

Principal

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