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Applying for: *
Applying for:BSc. NursingPBB.Sc NursingM.sc.Nursing
Name *
Date of Birth *
Age *
Sex *
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Address for Communication & Telephone No. (with STD Code) *
Name of the Degree
Mobile *
Fax
E-mail *
Nationality *
Permanent address & Telephone No(With STD Code)*
Marks secured in Degree Examination (Fill in appropriately as per the course )
I year
II year
III year
IV year
Grand total
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Merit/grade
Name of the Institution
Name of the University
Proof of date of birth
Degree Mark card & degree certificate/Provisional Degree certificate
Course & conduct certificate (upload)
