Application Form

Admission Number:

Students Information

Full Name*

Dob

Father Name*

Father Number*

Mothers Name*

Mobile Number*

Natianality*

Caste*

Sex*

Nationality Citizenship No.

Course Apply For:

GNM

B.Sc. Nursing

P.C.B.Sc. Nursing

Marks Scored in Class XII
Subject	Scored
Lang-I
Lang-II
Chemistry
Maths
Biology
Physics
Total
Percentage

Last Exam Passed:

Board Name:

Year of Passing:

Registration No.:

Name and address of school last attended:

Student Contact Information

Permanent Address :

Student Mobile Number :

Local Guardian Address :

Relation with Student :

Mobile Number :

Document Required Affix Photocopies (Original to be Produced at the time of Admission)

Declaration

I/We pledged that all information provided herewith is true to best of our knowledge. I/We fully agree to abide by all the policies , rules and regulations of the institutions and in case of non-confirmation would accept the verdict of the institution as the final. I/We also understood and accept that in case of discontinuation of the course for any reason. I/We shall forgo the entire fee including deposite paid to the institution and not claim any reimbursements for compensations.

*Antiragging affidavit has to be submitted before joining.

Date:

Place:

Signature of Father/Guardian

Signature of Student

For Office Use Only

FEES DETAILS

Course	1st Year	2nd Year	3rd Year	4th Year

Admitted By

Name:

Mobile Number:

Verified By

Name:

Entered By

Name:

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SOWRABHA INSTITUTE OF NURSING SCIENCE

SOWRABHA INSTITUTE OF NURSING SCIENCE

REGISTER OFFICE :

CAMPUS OFFICE :

Application Form

Students Information

Course Apply For:

Student Contact Information

Document Required Affix Photocopies (Original to be Produced at the time of Admission)

Declaration

For Office Use Only

FEES DETAILS

Admitted By

Verified By

Entered By

SOWRABHA INSTITUTE OF NURSING SCIENCE