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Home
Admission
Admission Criteria
Admission Form
Courses
Affiliations
Faculty
Infrastructure
Administration Block
Study Block
Laboratories
Sports Block
Recreation Room
Sick Room
Hostel
Canteen/Mess
Auditorium
Conference Hall
Guest House
News & Events
Results
Other Info
Scholarships
Placement
Our Hospitals
Admission
Form
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Admission
Admission Form
Admission Form
Fill in all required fields. Fields marked
*
are mandatory.
Apply For
*
— Select Course —
B.Sc. Nursing
GNM (Staff Nurse)
ANM (Female Worker)
NANNY
Emergency-cum Ambulance Attendant
Operation Theatre Attendant
Hospital & Home Based Care Attendant
Diploma in Fire Safety
Advance Diploma in Fire Safety
Course in Fireman
Industrial Safety
Personal Information
Name of Candidate
*
Father's Name
*
Mother's Name
*
Date of Birth
*
Gender
— Select —
Male
Female
Category
— Select —
General
SC
BC
Address
*
Contact Details
Email
*
Mobile
*
Alternate Mobile
Academic Qualifications
Matric / 10th Marks
*
10+2 Marks & Stream
*
Attachments
(jpg / PNG only — optional)
Candidate Photo
10th Certificate
10+2 Certificate
Declaration
I solemnly declare that I have filled in the application form in my own hand and if the information given in it is found incorrect at any stag my candidate for the admission to the course shall stand cancelled. I also declare that I have read all the information rules and regulations in the College & University prospectus and I will abide by them.
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