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Government of Karnataka GADAG INSTITUTE OF MEDICAL SCIENCES, GADAG Mallasamudra, Gadag582103 E-mailID:[email protected] web:www.karnataka.gov.in/gimsgadag BROCHURE FOR 2020-21 MBBS ADMISSION Admission officer:[KEA]. Mr. Ramesh- Phone: 7676097137 Principal office:-08372- 297274 www.Karnataka.gov.in/gimsgadag College fee to be paid at Corporation Bank, Puttaraj Statue circle, Gadag or online money transfer is accepted only from students account. TOTAL COLLEGE FEES; 74350/- (Excluding Hostel Fees) Account name: THE PRINCIPAL GIMS GADAG Account number: 006200101035910 IFSC code: CORP0000062 IMPORTANT 1. No forms/proforma will be issued at GIMS office as they are made available in GIMSwebsite. 2. NO MANAGEMENT SEATS AVALIABLE IN THIS GOVERNMENTCOLLEGE. 3. The mobile contact number that will be furnished to the Principal office the same will be submitted to the University. During examination time, the OTP from University will be sent to the same number for filing the examination forms. Therefore, STUDENTS ARE HEREBY INSTRUCTED TO RETAIN THE SAME MOBILE NUMBER THROUGH OUT THE COURSE. 4. Please call in office Timings [Holiday list and Map for CollegeEnclosed.] 5. An Induction programme for all I MBBS students will be held in first week of August 2020. 6. Kindly confirmif therei sany bandh or harthalandplan accordingly. Second Saturday is institute holiday .bank holidays are on 2nd and 4th Saturdays. There is no accommodation available for Parents in girls and boyshostel. 7. Kindly get all the documents required for admission. If any documents are missing your admission will be delayed as well as you will be responsible forconsequences.

BROCHURE FOR 2020-21 MBBS ADMISSION...FORM-II GADAG INSTITUTE OF MEDICAL SCIENCES, GADAG TO BE FILLED BY THE CANDIDATES FOR OFFICE USE (TO BE FILLED IN BLOCK LETTERS ONLY) Particulars

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  • Government of Karnataka

    GADAG INSTITUTE OF MEDICAL SCIENCES, GADAG Mallasamudra, Gadag– 582103

    E-mailID:[email protected] web:www.karnataka.gov.in/gimsgadag

    BROCHURE FOR 2020-21

    MBBS ADMISSION

    Admission officer:[KEA]. Mr. Ramesh- Phone: 7676097137

    Principal office:-08372- 297274 www.Karnataka.gov.in/gimsgadag

    College fee to be paid at Corporation Bank, Puttaraj Statue circle, Gadag or online money transfer is accepted only

    from students account.

    TOTAL COLLEGE FEES; 74350/- (Excluding Hostel Fees)

    Account name: THE PRINCIPAL GIMS GADAG

    Account number: 006200101035910

    IFSC code: CORP0000062

    IMPORTANT

    1. No forms/proforma will be issued at GIMS office as they are made available in GIMSwebsite.

    2. NO MANAGEMENT SEATS AVALIABLE IN THIS GOVERNMENTCOLLEGE.

    3. The mobile contact number that will be furnished to the Principal office the same will be

    submitted to the University. During examination time, the OTP from University will be sent to

    the same number for filing the examination forms. Therefore, STUDENTS ARE HEREBY

    INSTRUCTED TO RETAIN THE SAME MOBILE NUMBER THROUGH OUT THE

    COURSE.

    4. Please call in office Timings [Holiday list and Map for CollegeEnclosed.]

    5. An Induction programme for all I MBBS students will be held in first week of August 2020.

    6. Kindly confirmif therei sany bandh or harthalandplan accordingly. Second Saturday is institute

    holiday .bank holidays are on 2ndand 4thSaturdays. There is no accommodation available for

    Parents in girls and boyshostel.

    7. Kindly get all the documents required for admission. If any documents are missing

    your admission will be delayed as well as you will be responsible forconsequences.

    mailto:[email protected]://www.karnataka.gov.in/gimsgadaghttp://www.karnataka.gov.in/gimsgadag

  • DOCUMENTS TO BE PRODUCED AT ADMISSION

    Sl no

    PARTICULARS

    1 Requisition letter addressed to the Principal, GIMS Gadag requesting for MBBS admission (proforma enclosed)

    2 Form-I and Form-II (proforma enclosed )

    3 KEA-NEET allotment order

    4 KEA-NEET marks card

    5 Admit card/ counseling letter results sheet (for All India Quota Students)

    6 Original challan for having paid college fee

    7 10thmarks card / 10thpassing certificate

    8 12thmarks card / 12thpassing certificate

    9 Students claiming reservation under Hyderabad- Karnataka region (article- 371J) shall submit Eligibility certificate

    10 Transfer certificate

    11 Study certificate from the Institute last attended

    12 Character and conduct certificates from the Institute last attended

    13 Caste certificate

    14 Income certificate

    15 Domicile certificate (other than Karnataka students ).

    16 Eligibility certificate from RGUHS (for students other than Karnataka PU board)

    17 Migration certificate from the University last attended (if Applicable)

    18 Migration certificate from the board if passed 12thstandard from board other than Karnataka PU

    Board

    19 Physical fitness certificate (Medical certificate) from GIMS teaching Hospital /District surgeon

    20 Regional Language and English translated caste certificates from eligible KEA-NEET students to be submitted during admission by SC/ST/CAT-1,2a,2b,3a,and 3b students who scored less than 50% and more than 40% marks in 10+2 (PCB) examination required for submission to MCI, New Delhi.

    21 Regional Language and English translated caste certificates from the eligible KEA-NEET/KEA- NEET students to be submitted during admission by SC/ST/CAT-1,2a,2b,3a,&3b students who scored less than 50% and more than 40% marks in entrance examination required for

    submission to MCI,New Delhi

    22 Annexure –I, Part-I:-Undertaking by the student to be typed in Rs.200/- E-stamp paper and duly attested by notary (proforma enclosed).

    23 Annexure I. Part-II:- Undertaking by parent /guardian-to be typed in Rs.200/- E-stamp paper and duly attested by notary (proforma enclosed)

    24 Undertaking -MBBS degree programme as per RGUHS curriculum- to be typed in Rs.50/- E-stamp paper and duly attested by a notary (proforma enclosed)

    25 Rural service bond by candidates who select MBBS seats in GIMS, Gadag-to be typed in Rs.100/- E-stamp paper and attested by a notary (proforma enclosed)

    26 Four (04) recent color digital passport size photographs. The photographs must indicate clearly the

    name of the candidate along with the date of taking the photograph. Candidates must Keep 8-10 identical photographs ready in reserve for further use.

    27 1 Quality zipped files with latest photographs affixed on it including name and address of the

    candidate. Please provide good quality thick folder for safe keeping of your ORIGINAL certificates voluntarily deposited with college. 1 folder file is required to keep the Xerox copies.

    28 5 self addressed Rs.30/-stamps for 5 envelopes individually.

    29 All the documents soft copy in pdf format to be mailed to [email protected]

    *16. Eligibility certificate available online www.ecms.online

    *19. Physical fitness certificate can be issued from GIMS, District Hospital.

    http://www.ecms.online/

  • OFFICE MEMORANDUM

    Sub: MBBS Phase-I admission through KEA Bangalore-2020 and voluntary deposition of original

    certificates /testimonials - reg

    Ref: KEA Bangalore online generated admissions order No: dt 2020

    Mr./Miss KEA-NEETNo. RankNo: ,Category

    Who has been selected and allotted to Gadag Institute of Medical Sciences, Gadag has

    Reported and provisionally admitted to MBBSPhase-Ion 2020 subject to the approvalof

    concerned authorities. He/she has submitted all relevant original certificates and testimonials to this

    college on own will on the condition that admission are subject to approval rules and of MCI, RGUHS ,

    Government of Karnataka and Ministry of health and family welfare, Government of India. The said

    student and parents have been informed that seat surrender if any will be directly to KEA, Bangalore.

    I understand that college authorities will make maximum efforts to accommodate students in hostel yet

    we understand their compulsions, and sharing of rooms maybe needed and voluntarily students will be

    taking rooms as per availability. Students are also at liberty to quit hostels and stay outside anytime

    during course, and its also responsibility of parents to check the wellbeing, food served ,and ragging

    issues which can also be assigned by concerned parents to local guardian, as warden of colleges will have

    to look after other regular responsibilities.

    In general I will ensure students don’t do combined study or any undue advances towards members of

    other sex so as to sway away from original purpose of getting education of MBBS availing government

    facilities and concessions

    Principal Gadag Institute of Medical Sciences

    Gadag

    To: The Candidate.

    CandidateName

    Address and PhoneNumber

  • OFFICE MEMORANDUM

    Sub: MBBS Phase-I admission through AIQ-NEET-2020 and voluntary deposition of original certificate /testimonials - reg.

    Reg: DGHS-ALL India Quota 2020 Medical Counseling Committee, New Delhi Online generatedfor provisional allotment letter with rank dt:

    Mr./Miss category seat Allotted Category-

    Merit/RankNo. RollNo. who has been allotted MBBS seat during first /Second /Third AlQ-

    2020 counseling to Gadag Institute of Medical Sciences , Gadag has reported and provisionally

    admittedtoMBBS Phase-Ion subject to the approval of concerned authorities. He/ She has

    submitted all relevant originals certificates and testimonials to this college on own will with the condition

    that MBBS admission are subject to approval and rules of MCI, RGUHS, Government of Karnataka and

    Ministry of health and family welfare, Government of India. The said student and parents have been

    informed that seat surrender if any will be directly to MCC, AIQ-NEET seat allotting cell ofDGHS.

    I understand that college authorities will make maximum efforts to accommodate students in hostel yet

    we understand their compulsions, and sharing of rooms maybe needed and voluntarily students will be

    taking rooms as per availability. Students are also at liberty to quit hostels and stay outside anytime

    during course, and its also responsibility of parents to check the wellbeing, food served ,and ragging

    issues which can also be assigned by concerned parents to local guardian, as warden of colleges will have

    to look after other regular responsibilities.

    In general I will ensure students don’t do combined study or any undue advances towards members of

    other sex so as to sway away from original purpose of getting education of MBBS availing government

    facilities and concessions

    To: The candidate,

    Candidatename:

    Address and phonenumber

    Parent of candidate shall agree to give correct address and Email id and contact phone numbers of self

    Parents address:

    Phone number

    Principal

    Gadag institute of medical sciences

    Gadag

  • FORM-I

    GADAG INSTITUTE OF MEDICAL SCIENCES,GADAG TO BE FILLED BY THE CANDIDATES FOR OFFICE USE

    (TO BE FILLED IN BLOCK LETTERS ONLY)

    Place: Signature of the Candidates:

    Date: Signature oftheParent :

    Sl. NO

    PARTICULARS INFORMATION TO BE FILLED

    1 Name of the Candidates as per 10thMarks

    card.

    2 Blood Group

    3 Father Name : Parents permanent Address:

    Phone No (of Student and parent/Guardian)

    And Email Ids (of Students and Parent

    guardian)

    4 Sex

    5 Caste Religion : Caste : Category :

    6 Nationality

    7 Allotment/Rank Details

    KEA-NEETNO: RANK: AIQ-NEET: RANK:

    8 Marks Scored in KEA- NEET/AIQ-NEET (Enclosed Details )

    Exam Passed

    Max Marks Marks Obtained

    % of Marks

    KEA- NEET

    AIQ-NEET

    Qualification Exam

    Register No in PUC/12thClass

    PUC/12thClass Passed Year Date Month Year

    Specify the name of the University / Board

    where you have studied PUC / 12thSTD.

    Total marks scored in optional subject in

    PUC / 12thStandard Max Marks Marks

    Obtained

    % of Marks

    Physics

    Chemistry

    Biology

    Total marks

    Marks scored in English subject in PUC /

    12TH Standard

    Max Marks Marks Obtained

    % of Marks

    Total marks scored in all subject in PUC /

    12TH Standard

    9 Date of birth (as per 10thmarks card) DD/MM/YYYY:

    10 Date of admission Date Month Year:

    11 Documents Enclosed (yes/no)

    Affix recent

    photograph

  • FORM-II

    GADAG INSTITUTE OF MEDICAL SCIENCES, GADAG TO BE FILLED BY THE CANDIDATES FOR OFFICE USE

    (TO BE FILLED IN BLOCK LETTERS ONLY) Particulars Information to be filled up

    1 Allotment No. KEA-NEET AIQ-NEET

    2 Date of admission

    3 Name of the candidate

    4 Father name (specify name of the guardian, if father is not alive)

    5 Occupation

    6 Permanent address of Parent

    7 Correspondence address of Parent

    8 Income of the Parent / guardian

    9 Place of birth

    10 Date of birth

    11 Religion caste category (sc/st/other category-please specify)

    12 Native district

    13 Karnataka/ non Karnataka

    14 Name of the former school/college studied

    15 Qualifying exam passed

    16 Whether vaccinated

    17 College fees paid at the time of admission

    18 Bank receipt no.& date : Transection ID & Reference number:

    1. IherewithgiveanundertakingthatIwilladheretotherulesofgoodconduct.And willbeingeneralobedientto

    the teachers and will not any way disturb the harmony of the college anddepartments.

    2. I will not myself indulge in any union activities or such activities undesirous of a medicalstudent.

    3. Astheparent, will notallowmychildormyselfinstigatemyward to putacasein courtsandwilltryto

    amicablysettle all such disputes firstly within collegeauthorities.

    4. I will agree voluntarily to deposit all my certificate and testimonials as prescribed by RGUHS

    forverification and admissionapproval.

    Full address of parent:

    Mobile number of the candidate:

    Email ID of Candidate:

    Place:

    Date:

    Mobile number and Email ID of Parent:

    (DO NOT PROVIDE EMAIL ID OFSTUDENT)

    Signature of the candidate

    Signature of the parents

  • ANNEXURE l – PART l

    UNDERTAKING BY THE STUDENT

    1. I, S/o/ D/o. of

    Mr./Ms. , have carefully read andfully

    understood the law prohibiting ragging and the directions of the Supreme Court and the

    Central/State Government in this regard.

    2. I have received a copy of the MCI Regulations on Curbing the Menace of Ragging inHigher

    Educational Institutions, 2009 and read it fully and explained to myward.

    3. I hereby under take that–

    I will not indulge in any behavior or act that may come under the definition of

    ragging I Will not participate in or abet or propagate ragging in any form,

    I will not hurt anyone physically or psychologically or cause any other harm.

    I will resubmit such a undertaking again yearly to the Principal GIMS and reiterate my

    commitment

    4. I hereby agree that if I found guilty of any aspect of ragging, I may be punished as per the

    provisions of the MCI Regulations mentioned above and/or as per the law in force without any

    warning ornotice.

    Signedthis dayof monthof year

    1. Witness (signature&address) Signature:-

    Address:

    Mobile Number:

    2. Witness (Signature &Address)

    SEAL & SIGNATURE OF

    THE GOVERNMENT NOTARY

    l. Party-Student

    ll. Party- Director GIMS Gadag

    TO BE TYPED IN RS-200 E-STAMP PAPER

  • ANNEXURE l, PART ll

    UNDERTAKING BY PARENT/GUARDIAN

    1. I F/O /M/o /G/o

    aged years,

    Working as (occupations), Resident of

    (Correspondence

    Address) have carefully read and fully understood the law prohibiting ragging and the

    directions of the Honorable Supreme Court and the Central/State Government in this regard as

    well as the MCI Regulations on Curbing the Menace of Ragging in Higher Educational

    Institutions,2009.

    2. I assure you that my son /daughter will not indulge in any act ofragging.

    3. I hereby agree that if he/she is found guilty of indulging in ragging, he/she may be

    punishedasper the provisions of the MCI Regulations mentioned above and/or as per the law

    inforce.

    4. I understand that college authorities will make maximum efforts to accommodate students in

    hostel yet we understand their compulsions and sharing of rooms maybe needed and voluntarily

    students will be taking rooms as per availability. Students are also at liberty to quit hostels and stay

    outside anytime during course, and its also responsibility of parents to check the regular wellbeing,

    food served ,and ragging issues which may arise, and this can also be assigned by concerned

    parents to local guardian, or themselves help the warden, as warden of colleges will have to look

    after other regular responsibilities of large number of students.

    5. In general I will ensure students don’t do combined study or any undue advances towards

    members of other sex so as to sway away from original purpose of getting education of MBBS

    availing government facilities and concessions

    6.

    7. I agree to submit such as undertaking yearly to the Principal,GIMS.

    Signedthis dayof monthof year

    1. Witness (Signature&Address) ( )

    Signature & address:

    2. Witness (Signature & Address)

    SEAL & SIGNATURE OF

    THE GOVERNMENT NOTARY

    l. Party-Parent/Guardian

    II. Party- Direction GIMS Gadag

    TO BE TYPED IN RS.200/-E-STAMP PAPER

  • UNDERTAKING ABOUT

    MBBSDEGREEPROGRAMMEASPERRGUHS CURRICULUM

    I, Son / Daughterof

    (herein after called the Natural Guardian of the Student) hereby give an undertaking that on admission to I

    MBBS at Gadag Institute of Medical Sciences, Gadag , during the year 2020-21 have read the rule No.11

    of the ordinance of Governing M.B.B.S Degree Programme of Rajiv Gandhi University of Health

    Sciences, Bangalore, vide Notification No.ACA/BOS- 27/97-98, dated: 24.03.1998, and I shall abide / by

    the RGUHSregulations.

    That no student shall be permitted to join Phase-II (Para Clinical & Clinical) Group of subjects

    until he / she Passes in the Phase-I (Pre-clinical) subjects for which he / she will be permitted not more

    than four chances (Actual Examination) provided four chances are completed within three years from the

    date of enrollment. My parent also give undertaking that my parent shall visit college every 6 monthly to

    enquire my progress w.r.t attendance andassessments.

    Witness:

    1.

    2.

    Signature of the student with full

    Address and phone number .

    Signature of parent

    I Party – Candidate

    II Party – Director

    Rs 50/- E-STAMP

  • EXECUTION OF RURAL SERVICE BOND BY CANDIDATES WHO SELECT MBBS SEATS IN GIMS, GADAG.

    l Mr./Ms. , S/o. /D/o. a

    candidate with KEA-NEET–2020AdmissionTicket/RollNo. Residing at

    have been allotted an MBBS

    seaton in

    vide admission order number

    dated and do hereby undertake on my own volition asfollows.

    In accordance with the Amendment to rule 11 of the Karnataka Selection of Candidates for

    Admission to Government seats in Professional Educational Institutions Rules, 2006, vide Government

    Notification- 1. No.HFW 79 RGU 2011 dated 17.07.2017 and amendment Act 2017 dated 06-07-2017, I

    am prepared on completion of the course to serve in any Primary Health Center or Primary Health Unit

    situated in Rural Areas in the State of Karnataka for a minimum period of ONE year, allotted to me,

    failing which I render myself liable to pay a penalty of rupees ten lakhs or any amount on decided by

    GIMS Governing Council or DME of Karnataka to Government of Karnataka and the institute as per rules

    of the government in force.

    What is stated above is true and correct as per present rules in forceas decided by the

    Government of Karnataka and I hereby undertake to act accordingly. I also understand that if such rules

    are changed or notified by Government I and my ward are duty bound to follow such rules also. I have

    read and understood the above statement made by my son/daughter on oath-& I have my un-equivocal

    consent to the same.I also understand that I /my ward will not claim any job in this regard.

    1. Signature of theCandidate

    2. Signature of the Parent

    (Father/Mother)

    Date:

    Place:

    SEAL & SIGNATURE OF

    THE GOVERNMENT NOTARY

    l. PARTY - Student

    II. Party_ Government ofKarnataka

    TO BE TYPED IN RS.100/- E-STAMP PAPER

  • REQUISITION LETTER FOR KEA STUDENTS

    To Date:

    The Principal,

    GIMS, Gadag.

    Sir,

    Sub: - Request for admission to I year MBBS course at GIMS, Gadag allotted through Karnataka Common Entrance Test – reg.

    Reg:-LetterNo. dated: of Executive DirectorKEA,

    Bangalore.

    As per the letter cited under reference, I, Mr/Ms.

    S/o,D/o. , bearing AdmissionOrderNo. ,

    KEA-NEET No. RankNo. who belongto category have been

    allotted MBBS seat at Gadag Institute of Medical Sciences,Gadagunder category.

    I am herewith voluntarily enclosing the original fee challan for having paid college fees along

    with necessary original documents. For due verification by RGUHS. Hence, I request your kind self to

    admit me in your institute for I MBBS course on my request and risk and I am aware that my admission is

    subject to the approval of the concerned competent authorities, for which GIMS, Gadag will not be held

    responsible for any consequences / objections those may arise in future with regard to my admission. Also

    the address provided to GIMS, Along With Phone Numbers, E-mail id are permanent as on date, and any

    changes will be intimated to GIMS.

    Yours faithfully,

    (Signature of the candidate)

    (Signature of the parent / Guardian)

    Place: Gadag

    Date:

    Permanent address of Parent

    With E-mail id or phonenumbers

  • REQUISITION LETTER FOR AIQ-NEETSTUDENTS

    To Date:

    The Principal,

    GIMS, Gadag.

    Sir,

    Sub:- Request for admission to I Year MBBS course at GIMS, Gadag allotted through All India Quota -reg.

    Sub:-ProvisionalAllotmentLetterofAIQ-NEET-UGMedicalOnlineAllotmentProcess

    Counseling- 2020Dated:

    As per the letter cited under reference, I, Ms./Mr. S/o,

    D/o. , bearingNEETNO

    RankNo. whobelongto category have beenallotted

    MBBS seat at Gadag Institute of Medical Sciences, Gadag under category.

    I am herewith voluntarily enclosing the original fee challan for having paid college fees along with necessary original documents.Hence, I request your kind self to admit me in your institute for I MBBS course on my request and risk and I am aware that my admission is subject to the approval of the concerned competent authorities. will not be held responsible for any consequences / objection those may arise in future with regard to my admission. Address provided by me, phone numbers, E-mail id of parent are accurate, permanent as on date and any charges if will be intimated to GIMS.

    Yours faithfully,

    (Signature of the candidate)

    (Signature of the parent / Guardian)

    Place: Gadag

    Permanent Adress of parent with

    Phone number and E-mail id

  • INFORMATION TO BE FILLED UP BY KARNATAKA KEA-NEET /

    ALL INDIA QUOTA STUDENTS (STRIKE

    WHICHEVER IS NOT APPLICABLE)

    1. Mr./Ms. have been selected to MBBS Coursethrough

    KARNATAKA KEA-NEET-2020 / ALL INDIA QUOTA and allotted to GIMS. Gadag. I am herewith submitting a requisition letter seeking for admission. My admission details are as follows:-

    KEA-NEET / AIQ-NEET Allotment No. and Date:

    a. KEA-NEET / AIQ-NEET RankNo.: b. Category: c. Allotted Category: d. Last Date for admission:

    LIST OF DOCUMENTS SUBMITTED BY Mr. / Ms……………………………………………………………..

    SL.N

    O

    PARTICULARS

    SUBMIT

    TED

    NOT

    SUBMITT

    ED

    NOT

    APPLICABLE

    1

    Requisition letter addressed to the Principal, GIMS , Gadag

    requesting for MBBS Admission

    2

    Form & Form-II

    3 KEA-NEET/ AIQ-NEET allotment order

    4 KEA-NEET/ AIQ-NEET marks card

    5 KEA-NEET/ AIQ-NEET Rank letter

    6

    Admit card / counseling letter / KEA-NEET results sheet (for AIQ-

    NEET Students)

    7

    Original challan for having paid college fee

    8 KEA Payment receipt

    9 10th

    marks card / 10th

    passing certificate

    10 12th

    marks card

    11

    Students claiming reservation under Hyderabad-Karnataka region

    (article-371J) Shall submit eligibility certificate

    12

    Transfer certificate

    13 Study certificate from the institute last attended

    14 Character and conduct certificates from the institute last attended

    15 Caste certificate

  • 16

    Income certificate

    17 Domicile certificate

    18

    Eligibility certificate from RGUHS (for students other than Karnataka

    PU board)

    19

    Migration certificate from the university last attended (if applicable)

    20 Migration certificate from the board if passed 12th

    standard from the

    board other than Karnataka PU board

    21

    Physical fitness certificate (Medical certificate from GIMS teaching

    hospital)

    22

    Regional language and English translated caste certificates to be

    submitted by SC/ST/CAT-l, 2a,2b,3a & 3b students who are eligible

    for admission with less than 50% and more than 40% marks in 10+2

    (PCB) Examination Required For Submission To MCI.

    23

    Regional language and English translated caste certificates to be

    submitted by SC/ST/CAT-l, 2a,2b,3a & 3b students who are eligible

    for admission with less than 50% and more than 40% marks in entrance examination required for submission to MCI

    24

    Annexure I, part I:- undertaking by the candidate/ student – to be

    typed in Rs.200/- E-stamp paper.

    25

    Annexure I, part II:- undertaking by the parent/ guardian– to be typed

    in Rs.200/- E-stamp paper.

    26

    Undertaking. MBBS degree programme as per RGUHS curriculum-

    to be typed in Rs.50/- E-stamp paper.

    27

    Execution of rural service bond by candidates who select MBBS seats

    in GIMS, Gadag- to be typed in Rs.100/- E-stamp paper.

    28

    Four (04) recent colour digital passport size photographs and one

    single file with latest photograph affixed on it, including name and

    address of the candidates.

    29

    Vehicle Driving related affidavit incase of parents allowing children

    to ride vehicle.

    30

    05 self addressed Rs 30/- stamped Envelopes for Correspondence.

    31 Environmental Pledge

    32 2 attested Xerox copies of all documents

    33 1 zipped quality file+ 1 folder file

    34 Aadhar card Xerox

    35 Birth Certificate original for AIQ

    Place: Gadag Signature of Candidate

    Signature of Parents

  • GENERAL INSTRUCTIONS FOR THE STUDENTS WHO ARE TAKING ADMISSION

    FOR

    l-MBBS COURSE AT GADAG INSTITUTE OF MEDICAL SCIENCES,

    GADAG ALLOTTED THROUGH KARNATAKA KEA-NEET/

    ALL INDIA QUOTA

    1. Students must report in principal’s office at GIMS for MBBS admission on or before date indicated on their selection letter issued by K-KEA-NEET / KEA-NEET AIQ-NEET at 10-00 am. If any student fails to report before last date indicated in the office letter, his /

    her admission will stand cancelled and the same will be intimated to concerned

    authorities.

    2. The students are instructed to download all the below mentioned forms and must be filled in by his / her own handwriting with blue or black point pen neatly and legibly

    in English or computer typed in capital letters only, except for signature and submit

    the same at the time ofadmission.

    3. One of the parent / guardian must accompany students at the time of admissionor demitting seats as certain documents are to be signed bythem.

    4. The admission process is likely to make two days. Outstation candidatesare requested to not cause hurry in admission or demittingseats.

    5. The admission offered to a candidate will be only provisional. DME & RGUHS arefinal authorities.

    6. The students are instructed to keep the 5 set Xerox copies with themselves of their original documents until they are returned from Rajiv Gandhi University of Health Sciences, Bangalore. Once submitted no original will be returned, pleaseco-operate.

    7. Overwriting, cutting, erasing in the form may lead to rejection and should be avoided. Check thoroughly whether you have filled all your relevant details correctly in the concernedforms.

    8. Important: No forms / proforma will be issued at GIMS office as they are madeavailable in GIMS website.www.Karnataka.gov.in/gimsgadag

    9. Institute working hours: 10.00 am to 1.30 pm and 2.15 pm to 5.30pm.

    10. Each candidate must submit the following original certificates shown below along with three sets of attested true copies. The originals and Xerox must be produced in the following sequence, failing to which there admission will be withheld and for that GIMS

    will not be heldresponsible.

    11. In case of AIQ-NEET/KEA-NEET seats-seat surrender procedure be duty followed. Kindly generate the online seat surrender receipt and contact the AIQ-NEET officer of GIMS Dr.Anand Hugar on 8971282391, message him. Please try to come on GIMS

    working day and remember Karnataka holiday schedules will be different working days

    are Monday to Saturday, SUNDAY WILL BE HOLIDAY. SECOND SATYRDAY AND GOVERNMENT OF KARNATAKA HOLIDAYS will BE HOLIDAYS AS WELL AS

    NATIONAL HOLIDAYS. KINDLY CALL ON OFFICE NUMBERS Mr.Ramesh 08372-297173/ 274/224 and speak in Hindi orKannada.

    12. Learning Kannada for a medical student may be necessary since MBBS studentsare interacting withpatients.

    http://www.karnataka.gov.in/gimsgadag

  • NOTE

    1. Students admitted to this institute are expected to strictly follow the codes ofdiscipline indicated by college authorities, university, andgovernment.

    2. Drinking alcohol, smoking or consuming any intoxicants by students is strictly prohibited. Misbehavior with girl students / women / patients will be dealt as perlaw.

    3. Ragging in any form is punishable by law. An undertaking to this effect signed by the candidate and his/her parent /guardian must be submitted at the time of admission

    compulsorily.(all fiveaffidavits)

    4. Candidates are advised to keep a printed copy of their completed application form along with forms for their record and future reference. You can photograph your submission

    too.

    5. As per RGUHS syllabus regulation 75% attendance in both practical’s and theory is a must. Nonadherence to such rules in force will invite disciplinary actions. It is also the

    duty of parents/guardians to periodically ask for Internal marks and attendance of their

    ward and participate in education process. Awhatsapp group will be created for this batch

    of students and maintained for the purpose of smooth conveyance of information

    Dr.Roopa. (9742118485) be sent a SMS to include parents name in the whatsapp group.

    Don’t include students nameplease.

    6. No vehicles are allowed to be kept by students or used in the college permises. All parents must agree to not allow their ward to not use any vehicles. If any parent wishes to

    allow wards to use vehicles, they must submit a undertaking in Rs.100/- bond paper

    towarden.

    7. Dress code – Decent formal dressing with shoes and socks is expected from both boys and girls during working hours when visiting library similar rules apply. While roaming

    in campus also kindly wear decentclothes.

    8. Library rules and regulations must befollowed.

    9. Any Incidents of Ragging please report to Dr.Myageri (9986028269) or Dr.Raju(Vice Principal9844480528.

    CONTACT DETAILS

    PHONE : 08372 297213, 297214 (office)297274

    FAX : 08372-297214

    WEBSITE : www.Karnataka.gov.in/gimsgadag

    E MAIL ID :[email protected]

    ADDRESS : Gadag Institute of Medical Sciences, Mulagund Road, Mallasamudra, Gadag. Distr:

    Gadag State: Karnataka Pin code-582103.

    http://www.karnataka.gov.in/gimsgadag

  • Check up will be done in first floor of GIMS Teaching Hospital/District Surgeon room

    The Karnataka Service Regulations (Act.32) KARNATAKA MEDICAL DEPARTMENT

    PHYSICAL FITNESS CERTIFICATE

    1) In do hereby certify that I haveexamined…………………………………………………

    ……………………………………………………………………………………………..

    a candidate for ……………………………………………………………………………..

    And that I cannot discover that she/he has any disease constitution affection or bodily

    infirmity except…………………………………………………………………………….

    I do not consider this disqualification for employment in the office of …………………….

    2) I am also satisfied by personal examination/from certificate produced by that the

    He/She was vaccinated/re-vaccinated within one week prior to the date of

    thecertificate.

    3) ……………………………..’s age is according to His/her ownstatement……………….

    years and byappearance about .......................................... year.

    Other Particular’s

    1. Height

    2. Weight

    3. Chest

    4. Vision

    MedicalSuperintendent,GIMS District Surgeon

    District Hospital, Gadag

  • GENERAL RULES & REGULATIONS OF GIMS HOSTELS

    1) Ragging in any form is banned inside and outside the campus. Is punishable.

    2) Students should strictly follow the timings of thehostel.

    3) Extended hours for studying in the library will be granted on prior writtenpermission.

    4) Visitors including parents/guardians are allowed to meet the students in the visitors

    lounge during visiting hours and not in their rooms. Overnight stay in the hostel is not

    allowed. Entertaining unauthorized guests will lead to severe punishment including

    expulsion from thehostel.

    5) Students are not allowed to stay in rooms other than the ones allotted tothem.

    6) Students are responsible for the safety of their belongings. Kindly report any themselves to warden office inworking.

    7) Use of tobacco in any form is strictlyprohibited.

    8) Consumption of alcohol is strictlyprohibited.

    9) Possession of weapons or dangerous chemicals of any kind is strictlyprohibited.

    10) Students will not get involved in political activities of any sort or participate inany anti-national and anti-social or undesirable activity inside or outside thecampus.

    11) Students are not permitted to stay in rooms during the college hours, unless they are

    ill. Any illness and medication student uses should be reported to the Warden. and

    principal.

    12) Students are not permitted to stay away from the hostel or leave station without theprior

    permission from thewarden/Principal.

    13) Student once admitted to the hostel, cannot vacate it without a written requestfrom

    their parents which must be authorized by the Warden/Principal.

    14) Meetings/gathering within the hostel are not permitted. Functions of anykind

    should have the prior permission of theWarden.

    15) Students are allowed to use table lamps, hair dryers, iron box and chargers. The useof

    other electrical appliances is notallowed.

    16) Students have to keep their room clean and neat, including bathroom andtoilet.

    17) Students are not allowed to have meals in their rooms except under specialconditions

    like illness etc. The permission of the warden is required in suchcases.

    18) Cooking is not permitted in the hostelrooms.

    19) Students are not allowed to use terrace for any purpose without the prior permissionof

    theWarden.

  • 20) Students are not allowed to use motor vehicles like bikes or cars. Those who are

    authorized to use vehicles are required to park in an orderly manner in the space

    provided. The students using vehicles should possess the valid driving license/ vehicle

    registrationdocuments.

    21) Any damage to the hostel property will attract a fine. The students residing in the room is

    responsible for any damage to the property within the room and will bear the cost of

    damage. In case of damage or loss of hostel property the cost will be recovered from the

    students of the hostel as decided by theWarden.

    22) All students are required to maintain high standards of discipline in the college campus

    and hostel premises. In case of breach of discipline and failure to abide by the rules and

    regulations, the hostel committee will render the students liable to disciplinaryaction.

    23) Any in disciplinary or undesirable activities occurring in the hostel should be broughtto

    the notice of theWarden/Principal.

    24) Warden/Principal / Director are the final authority to take up decisions in anyuntoward

    incidents.

    SD/-

    Wardens of Boys Hostel

    SD/-

    Wardens of Girls Hostel

    SD/-

    Principal

    Gadag Institute of Medical Sciences

    Gadag

  • GIRLS HOSTEL RULES

    1. Follow the hostel timingsstrictly a. During the month ofexamination b. -timing to go out-morning after 7.00 am c. -timing to come in evening before 8.00

    2. Fine for Keeping tap open – 1000/-Rs per person. 3. Fine for keeping fan, bulbs and electrical items on Rs – 500 per head

    4. Mess bill has to be Paid before 10thof every month, if delayed 50/-Rs fine

    a. Per day will becollected. 5. If the students want to go out of campus they have to takewritten

    permission of warden.

    6. Mess timings:

    a. Tiffin:7.30am-9.00am b. Lunch:12.30pm-3.00pm c. Dinner:7.30pm-9.00pm

    7. Messbill–2600Rspermonth–fixed,deductionwillbeconsideredif remain absent for continuous fivedays.

    8. No male relative is allowed to enter the room withoutpermission. 9. Singleladycompanionisallowedtostaywiththestudentwithwarden

    permission.

    10. No single rooms are available for what so ever reason and such requests will not be entertained.

    ***

    If students violate hostel rules and if any untoward incident happens,

    students are responsible themselves & strict action will be taken.

    SD/-

    Chief Warden

    Girls Hostel

    GIMS Gadag

    Contact Number:

    Dr.Sukanya:9448117524.

    Hostel :8762488781.

  • UNDERTAKING BY THE PARENT

    Rs 100/- bond paper to Hostel Warden. Vehicle DL Xerox copy to be submitted with this bond. Of the student who wishes to keep vehicle in the campus.

    I. father of / guardian of/mother of

    student of I / II /III MBBS herewith give a undertaking to this effect that my child /ward

    has keptavehicle Model

    Make

    VehicleNo. at GIMS campus.He/shein legally eligible to drive

    vehicle and His/her vehicle DL is valid DLNois Any Mishaps/

    accidents, any injuries to self others an account of driving by my ward is solely the

    responsibility of my child and myself. I will not allow such vehicle to bedriver

    rashly or cause physical injury to other citizens. While driving such a vehicle my

    child will ensure dignity of my family, college and such vehicle permission will

    not be misused by letting or renting vehicle or flouting the MV act. Also such

    vehicle driver shall display on vehicles the sign L for learner and peruse Helmets

    for himself/herself and the pillion rider.

    Signature of child wishing to

    Usevehicle Signature ofparent

    Mobile number Address

    Witness (address with mobileno)

    1.

    2.

  • ENVIRONMENTAL PLEDGE

    (Each student must give this pledge)

    I S/O,D/O

    Hereby Pledge that I voluntarily agree to plant and maintain tree in my college

    campus, and I will also take care of the plants/trees entrusted to me by the college

    authorities. I shall participate in all such environment friendly activities assigned to

    me with full dedication.

    SignatureofCandidate Signature ofPar

  • GADAG INSTITUTE OF MEDICAL SCIENCES, GADAG REVISED FEES STRUCTURE FOR MBBS COURSE FOR ACADEMIC YEAR 2020-21

    Sl No Particulars

    1st Year

    GM/OBC SC/ST AIQ

    1 Registration Fee (University) 3000 3000 3000

    2 Admission Fee (University) 500 500 500

    3 Sports Fee (University) 4 1/2 years 900 900 900

    4 Student Welfare fund (to the University) 4 1/2

    year 450 450 450

    5 Helinet Fee (University) 4 1/2 year 4500 4500 4500

    6 Tuition Fee 50000 50000 50000

    7 Library Fee 2000 2000 2000

    8 Sports Fee (college) 450 450 450

    9 Laboratory Fee

    10 Medical examination Fee 550 550 550

    11 Caution Money Deposit (Refundable) 2000 2000 2000

    12 Alumni Association Fee (life time) 800 800 800

    13 IA Fees 350 350 350

    14 Association Fees 550 550 550

    15 Magazine Fee 550 550 550

    16 Kannada Sanga 250 250 250

    17 Identity Card 250 250 250

    18 Research Fees 1250 1250 1250

    19 Digital Library (College) 4000 4000 4000

    20 Cultural activities (College) 1500 1500 1500

    21 Literary activities (College) 500 500 500

    GRAND TOTAL 74350 74350 74350