Select Course :

Specialisation :

Specialisation Medical and Surgical Nursing Obstetrics and Gynaecology Nursing. Paediatric.

Full Name of the Applicant :

Mobile No:

Email:

Name of the :

Parent   
 Guardian

Mobile No:

Date of Birth :

Age :

Choose your Nationality:

Indian International

Country :

Place of Birth :

Gender :

Religion :

Mother Tongue :

Whether belongs to SC/ST/BC or, any other Reserved category

Yes    No

Occupation of

Parent   
 Guardian

Annual income of

Parent   
 Guardian

Address :

Permanent Address:

Name of the College / School last attended :

Qualifying Exam passed :

Select your option 12th ICSE 12th Board CBSE 12th Board HSSLC Intermediate PUC

Medium of Education:

English     Others

Month & Year of Passing :

Marks obtained in the Qualifying Examination :

10th

12th