Rural Nursing Training Institute GURU SADAN, HULLAHERI MOR,V.P.O

1.

Name of The Program (Whichever is applicable)

Bsc. (N)	P.B. Bsc (N)	GNM
ANM	BMLT	DOTT
BPT	DMLT

2.

Name Of Candidate

3.

Date of Birth
(DD/MM/YYYY)

4.

Gender

Male

Female

5.

Married Status

6.

Father's Name

7.

Mother's Name

8.

Nationality

State

9.

Postal Address

10.

Permanent Address:

Pincode		Tel No. (With Pin Code)
Mobile No.		Email ID

11.	Categories
	Certificate to be attached Reservation Benefits as per Govt. Rules

12.

Fathers's / Guardian's Particulers

Occupation
Nationality
Annual House Hold Income (Rs.)

13.

Comment of HOD/Principal

14.

Academic Qualification

Exam	Board / University	Year of Passing	Roll No.	Subjects	Marks Obtained	Max Marks	% Age of Marks
Matric
10+2 or Equivalent
Other

Select a file:

Registration/ Admission Form:

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