Application Form For Admission To M.Sc. Nursing

Candidate Full Name * :

Date of Birth * :

Sex * :

Nationality * :

Email ID * :

Mobile No * :

STD Code / Telephone * :

Candidate's Photo :

Signature of the candidate :

Address * :

Pin Code * :

State * :

Admission Preferences * :

Preference 1:

Preference 2:

Preference 3:

Preference 4:

Preference 5:

Name of College & University passed from * :

Academic Record (Year-wise):

Other PG Qualification? *

If YES, provide details:

Examination	Board/University	Passing Year	Attempt	Marks Obtained	Out Of	Percentage

Admitted to any other PG Course? *

Details (If any):

Declaration:

a) I hereby declare that the above information is true and complete to the best of my knowledge.
b) If admitted to this Institution I shall abide by its rules and regulations.
c) I have read and understood all the provisions contained in the brochure.