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BHOPAL NURSING COLLEGE PROSPECTUS
Admission for
POST BASIC B. Sc NURSING
(2 years Degree course)
&
GENERAL NURSING AND MIDWIFERY
(3½ years GNM course) Recognized by Indian Nursing Council, New Delhi
Approved by : MP Nurses Registration Council
Affiliated to : Barkatullah University, Bhopal
Indian Council of Medical Research, Department of Health
Research, Ministry of Health & Family Welfare, Govt. of India,
Bhopal Memorial Hospital & Research Centre, Raisen By-pass Road,
Karond, Bhopal – 462038.
Phone No.: 0755-2742279, 0755-2742212-16 Extn. 8821, 8803, 8805, 8831
Fax : 0755-2748309
Email : [email protected] Website : www.bmhrc.org
Cost of application with prospectus
Rs 500/- by Hand
Rs 550/- by Post
Page 2 of 23
INTRODUCTION
Bhopal Memorial Hospital & Research Centre is a 350-bedded super-specialty
hospital situated at Bhopal, (MP). This institute was started as per the directive of the
Honorable Supreme Court of India to provide super-specialty care to the victims of the
Bhopal Gas Tragedy (1984) as well as to extend its services to the public at large.
Presently the hospital is run by Indian Council of Medical Research, Department of
Health Research, Ministry of Health & Family Welfare, Govt. of India. Bhopal
Memorial Hospital & Research Centre also have highly advanced Research Centre,
Nursing College & a Paramedical Institute.
Bhopal Nursing College in Bhopal Memorial Hospital & Research Centre
provides quality training for Post Basic B.Sc Nursing (since November 2003) and
General Nursing & Midwifery (from 1st July 2011). It is recognized by Indian Nursing
Council, MP State Nursing Council, and affiliated to Barkatullah University, Bhopal.
MISSION
Bhopal Nursing College delivers excellent academic programs and engages in research
and service to provide quality patient care and seeks to demonstrate the compassion
(Homage & Hope) and provide soothing and reassuring feeling to the gas victims and
their families.
VISION
Bhopal Nursing College is envisages to quality Nursing education that will be
recognized as a leader in health professional education by qualified applicants,
graduates, and employee. We make a difference in the lives of our students, the
practice of our profession and the health of the people we serve.
PHILOSOPHY
Bhopal Nursing College believes that
- Health is a state of well-being that enables a person to lead a physical,
psychological, social and economically productive life. Health is a right of
all the people.
- Nursing is a dynamic, therapeutic and educative process in meeting the
health needs of the society, assisting the individual & family to achieve their
potential for self direction.
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- All-round development of the student is important to make them an
individual, a citizen as well as professional nurse.
- Nursing is a profession, which is influenced by advances in science and
technology, encouraging innovations in nursing and applying evidence
based practices.
- Nursing is based on values of caring and aims to help individuals to attain
independence in self-care.
- The teacher have the responsibility to be a role model and create learning
environment that enables students to acquire inquiry driven, self directed
learning and foster an attitude of life long learning.
Post Basic B.Sc (Nursing) programme:
Aims
The aim of post Basic B.Sc (N) program is to upgrade the Diploma (GNM) nurses to
- Assume the responsibilities as professional, competent Nurse and Midwife in
providing preventive, promotive, curative and rehabilitative services.
- Expect to assume the role of teacher, supervisor, manager and researcher in the
clinical & community health settings.
Objectives
The objectives of Post basic B.Sc (Nursing ) programme are to :-
- prepare nurses with a sound knowledge in nursing to enable them to
function as an efficient member of the health team, with the competences
in all level of health care settings.
- help nurses and develop an ability to co-operate and co-ordinate with
members of the health team.
- provide personal and professional development to contribute at its
maximum to the society.
- serve as a base for further professional education and specialization in
nursing.
- prepare nurses to keep pace with advance professional and technological
developments and use the same for providing nursing care services.
- Emphasize the importance of continuing learning for their personal and
professional development.
- Enable professional nurse to participate in research activities and utilize
research findings in improving nursing practice.
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- Demonstrate leadership qualities and managerial skills in different health
settings.
Diploma in General Nursing & Midwifery Programme
Aims
- Prepare nurses with sound knowledge & skill programme in nursing which
can serve as a base for further professional education.
- Help nurses to develop an ability to co-operate and co-ordinate with
members of health team and assume responsibilities as professional,
competent nurses and midwife at basic level in preventive, promotive,
curative and rehabilitative services.
Objectives
The objectives of GNM programme are to:-
- Prepare nurses with a sound knowledge and skills in nursing and enable them to
function as an efficient member of the health team, with the competencies at all
level of health care settings.
- plan and carry out appropriate action to meet nursing care needs
- apply problem solving techniques in nursing practice
- Apply knowledge from the humanities, biological and behavioral sciences in
nursing practice.
- demonstrate use of ethical values in their personal and professional life
- evaluate the effectiveness of nursing care
- Recognize the need for continuing education for professional development.
CURRICULAR ZONE
Lecture Halls
Bhopal Nursing College has spacious lecture halls with comfortable seating
arrangements and equipped with advanced teaching aids.
Library
Bhopal Nursing College has centralized air conditioned library with a wide collection
of books and also National & International journals are subscribed on regular basis
with e-journal facility.
Information Technology Centre/Computer Lab
The college has well established computer lab with internet facility which is accessible
to all learners so as to keep themselves updated with the current trends and
technologies in nursing.
Page 5 of 23
Maternal and Child Health (MCH) Lab
Maternal and child health is prime attention in our country. The MCH lab is equipped
with maternity examination model, Gynecological examination model, delivery model,
charts and other equipments.
Nursing Foundation Lab
Nursing lab is a skill based profession. Nursing Foundation Lab is equipped with all
advance equipments, articles, model, charts and mannequins to enhance the nursing
skills of the learners.
Community Health Nursing Lab
Community lab is well equipped to develop skills for rendering service in rural and
urban community.
Nutrition lab
Nutrition lab is equipped and well furnished with utensils, nutritional charts, models. It
is well ventilated, lighting, and adequate water facilities.
Pre-clinical Science Lab
The lab is equipped with models, charts, specimen, microscope and slide to provide
better understanding of human Anatomy, Physiology and Microbiology.
Audio-visual lab
The audiovisual lab consist of OHP, LCD, T.V, posters, Flannel board, model and
other teaching learning materials are available in the lab for effective teaching learning
process.
Multipurpose Hall (Auditorium)
Institute has an advanced auditorium with centralized air condition, adequate seating
facility, modern light system and digital sound facility. Individual mike control facility
is also available on chairs.
CLINICAL ZONE
Parental Hospital
Bhopal Memorial Hospital & Research Centre is the parent Hospital of Bhopal
Nursing College. It is 350 bedded Super- Specialty Hospital with advanced diagnostic
laboratory. Hospital is primarily concerned to Gas victims.
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Affiliated Hospital
Bhopal Nursing College is affiliated with 320 bedded Government Jai Prakash
Hospital, Bhopal for Maternity and Paediatric training.
COMMUNITY ZONE
Student of Bhopal Nursing College/school are regularly utilizing the rural and urban
and community area covered by Community Health Centre, Gandhi Nagar, Bhopal.
Activities of the nursing students includes early identification of health problems by
regular home visit, participation in National Health Programme, like Pulse-Polio
Immunization programme, Community Nutrition Development Programme,
Reproductive and Child Health Services and School Health services etc.
CO-CURRICULAR ZONE
Recreational Activities
Facilities of in-door games like chess and carom, and out-door games like badminton,
volleyball, hand ball, ring throw, cricket and football are available for recreational
purposes of students.
Cultural Activities
Cultural progamme are organized on various occasions. The students are encouraged
to participate in dance, skit, mime show, tableau etc in promoting inherent talents of
the students.
COURSES OFFERED
S.No. Course Duration University/Board Seats available
1 P.B.B.Sc. Nursing 2 years Barkatullah
University, Bhopal
50
2 General Nursing &
Midwifery (GNM)
3½ years MP Nurses
Registration Council,
Bhopal.
50
Page 7 of 23
ELIGIBILITY CRITERIA (as per Indian Nursing Council New Delhi)
General Nursing and Midwifery
• Minimum and maximum age for admission will be 17 and 35 years. As on
01.08.2014 There is no age bar for ANM/LHV.
• Minimum education:
i. 10+2 class passed preferably Science (PCB) and English with aggregate of
40% marks.
ii. 10+2 in Arts (Mathematics, Biotechnology, Economics, Political science,
History, Geography, Business studies, Accountancy, Home Science,
Sociology, Psychology, Philosophy) and English core/English Elective or
Health care Science – Vocational stream only, passing out from recognized
Board under AISSCE/CBSE/ICSE/ SSCE/HSCE or other equivalent Board
with 40% marks.
iii. 10+2 vocational ANM under CBSE board or other equivalent board from
the school and recognized by Indian Nursing Council with 40% marks.
iv. Registered as ANM with state Nursing Registration Council.
• Student shall be medically fit.
• Students qualified in 10+2 Arts or Science examination or Health care Science-
Vocational stream ONLY conducted by National Institute of Open School with
40% marks.
Post Basic B.Sc. Nursing
Passed the Higher Secondary or Senior Secondary or Intermediate or 10+2 or an
equivalent examination recognized by the university for this purpose. Those who have
done 10+1 in or before 1986, will be eligible for admission.
Obtained a certificate in General Nursing and Midwifery and registered as R.N/R.M.
with the State Nurses Registration Council. A male nurse, trained before the
implementation of the new integrated course besides being registered as a nurse with
State Nurses Registration Council, shall produce evidence of training approved by
Indian Nursing Council for a similar duration in lieu of midwifery in any one of the
following areas:
• O.T. Techniques
• Ophthalmic Nursing
• Leprosy Nursing
• TB Nursing
• Psychiatric Nursing
• Neurological and Neuro Surgical Nursing
• Community Health Nursing
Page 8 of 23
• Cancer Nursing
• Orthopedic Nursing
• Candidates shall be medically fit.
Seats Available
For both Post Basic B.Sc Nursing program and GNM program 50 seats are
available. 15% seats reserved for SC candidates, 7.5% seats reserved for ST
candidates, 27% seats reserved for OBC candidates,
The 05 seats in Post Basic B.Sc Nursing course will be considered for Sponsored
candidates who are in the employment of Hospitals/Institutions under
Central/State Govt. or college of Nursing/Schools of Nursing and whose names
are sponsored by their employer. The original application of the sponsored
candidate must be forwarded by the employer, weightage of 05 marks in the
entrance test will be given to the sponsored candidate. The sponsored candidate
if selected should submit a relieving letter confirming sponsorship at the time of
the admission. In event of non availability of eligible sponsored candidates, the
seats thus remaining vacant will be open to other candidates
.
PROCEDURE TO APPLY
- A candidate seeking admission to Post Basic B.Sc Nursing or Diploma in General
Nursing & Midwifery course shall submit filled application form attached with
prospectus. It can be obtained from the office of the Bhopal Nursing College on
payment of Rs. 500/- through Demand Draft in favour of Bhopal Memorial
Hospital & Research Centre, payable at Bhopal.
- Prospectus can be obtained through Post by sending a Demand Draft of Rs 550/-
in favour of Bhopal Memorial Hospital & Research Centre, payable at Bhopal.
- Last date of receiving DD for sending Application form with prospectus
through post is 26/05/2014 up to 5.00 PM
- Closing date of filled application 06/06/2014 up to 5:00 pm for both GNM and
Post Basic B.Sc Nursing programme.
- The College does not take any responsibility for Postal Delay/Losses.
- Fees once paid will not be refunded in any circumstances.
Page 9 of 23
- Attested copies of the certificates along with filled application form should be
submitted to The Office of Nursing College, Bhopal.
- In respect of candidates belonging to a scheduled caste, scheduled Tribe or OBC
community an attested copy of certificate from any of the following authorities.
District Magistrate / Additional District Magistrate / Collector / Deputy
Commissioner / Additional Deputy Commissioner / Deputy Collector / 1st class
Stipendiary Magistrate / City Magistrate / Sub divisional Magistrate / Taluk
Magistrate / Executive Magistrate / Extra Assistant Commissioner / Chief presidency
Magistrate/Additional chief Presidency Magistrate / Presidency Magistrate / Revenue
officer not below the rank of Tehsildar and Sub-Divisional officer of the area, where
the candidate and/or his/her family normally resides.
Postal Address
Principal, Bhopal Nursing College, Bhopal Memorial Hospital & Research Centre,
Raisen By-pass Road, Karond, Bhopal (MP). Pin 462038.
SELECTION PROCESS
GNM & Post Basic B.Sc. Nursing
Entrance Test
Duration – 2 Hours
Marks – 100
Time – 11:00 am to 1:00pm
Venue – Bhopal Nursing College, BMHRC, Bhopal.
Date – 02/07/2014, Wednesday for GNM.
25/06/2014, Wednesday for Post Basic B.Sc. Nursing.
� Admissions of the candidate are strictly on merit basis of entrance test.
� Entrance Examination will be conducted in English language only.
� The centre of examination will be Nursing College, BMHRC. Bhopal.
� Result of successful candidates in selection test will be displayed in college
notice board as well as BMHRC website (www.bmhrc.org).
� Individual correspondence/telephonic information in this regard will not be
entertained.
� Admit cards for appearing in entrance test will be issued to eligible candidates.
If the candidate does not receive admit card by 20/06/2014 , he/she may contact
Page 10 of 23
college office personally on or before 24/06/2014 between 10.00am to 5.00pm
(Excluding lunch hours 2:00-3:00 PM)
� Admits cards will be sent by post, however college will not be responsible for
postal delay/loss.
Syllabus for GNM Entrance Examination as follows:
Question paper consists of 5 parts of multiple choice questions and distribution of
marks as follows.
Part Subject Maximum
Marks
A Physics 20
B Chemistry 20
C Biology 30
D General Knowledge 15
E English 15
Total 100
Entrance examination syllabus for Post Basic B.Sc. Nursing
- Fundamentals of Nursing
- Medical and Surgical Nursing including Anatomy, Physiology and
Pharmacology
- Maternal Health Nursing
- Child Health Nursing
- Community Health Nursing
- Mental Health Nursing
- Professional Trends in Nursing.
Page 11 of 23
FEE STRUCTURE
Post Basic B.Sc. NursingProgram
S.No List of Items
PBBSc 1st year
In Rupees
(Per annum)
PBBSc 2nd year
In Rupees
(Per annum)
1. Registration fees 5 --
2. Development fee 600 600
3. Mark sheet charges 200 200
4. Tuition fee 250 250
5. NSS Fee 20 20
6. Identity card 50 50
7. Library & breakage 250 250
8. Health fee 100 100
9. Games fee 1000 1000
10. SNA 1500 1500
11. SAF(Student Aid fund) 20 20
12. Enrolment fee 250 --
13. Annual Examination fee
(Theory) 2700 2700
14. Annual Examination fee
(Practical) 200 200
15. Hostel fee 1200 1200
16. Security Money (refundable) 5000 --
17. Transcript Fee (Optional) -- 2000
18. Water and Electricity Fee 2000 2000
19. Mess charges 1500 per month 1500 per month
Page 12 of 23
General Nursing and Midwifery Program
S.No List of Items
GNM
1st year
(Per
annum)
GNM
2nd year
(Per
annum)
GNM
3rd year
(Per
annum)
GNM
Internship
1. Registration fees 5 -- -- --
2. Development fee 600 600 600 600
3. Mark sheet charges 200 200 200 200
4. Tuition fee 250 250 250 175
5. Identity card 50 50 50 50
6. Library & breakage 250 250 250 175
7. Health fee 100 100 100 50
8. Games fee 1000 1000 1000 500
9. S.N.A 1500 1500 1500 750
10. SAF(Student Aid fund) 20 20 20 20
11. Enrolment fee 100 -- -- --
12.Annual Examination fee
(Theory) 1000 1000 1000 500
13.Annual Examination fee
(Practical) 300 300 300 150
14. Security Money (refundable) 5000 -- -- --
15. Transcript Fee (Optional) -- -- -- 2000
16. Hostel fee 1200 1200 1200 600
17. Water andElectricity Fee 2000 2000 2000 1000
18. Mess charges 1500
per month
1500
per month
1500
per month
1500
per month
Note:
• All University/Nursing council fees/dues will be charged as per
University/council norms & are subject to change accordingly.
• No fee shall be refunded after admission acceptance.
• Security money will be refunded after the completion of course.
• Clinical fee, Transportation fee, Graduation & Annual Day fee will be as per the
decision of management.
• All the fee should be paid at the time of admission only.
Page 13 of 23
LEAVE RULES
Post Basic B.Sc Nursing
Medical leave - 10 days
Gazette holidays - 3 weeks
Preparatory Holidays - 4 weeks
Vacation - 8 weeks
GNM
Medical leave - 10 days
Gazette holidays - 3 weeks
Preparatory Holidays - 1 week
Annual Vacation - 30 days
HOSTEL ACCOMMODATION
- Residence in the hostel of the institute is compulsory for female candidate
admitted to Post Basic B.Sc. Nursing & GNM programmes.
CODE OF CONDUCT FOR STUDENTS
Maintenance of discipline among students
1. All powers relating to discipline and disciplinary action are vested in the
Director/Principal.
2. Without prejudice to the generality of power to enforce discipline under the
rules. The following shall amount to act of gross indiscipline.
a) Physical assault or threat to use physical force against any member of the
teaching or non-teaching staff of any department/centre or any other persons
within the premises/campus.
b) Carrying of any weapon to threat.
c) Violation of the status dignity and honor of students belonging to the
Scheduled Castes, Scheduled Tribes and Other Backward Castes.
d) Any attempt of bribing or corruption in any manner.
e) Destruction of institutional property.
f) Creating ill will or intolerance on religious or communal grounds.
g) Causing disruption in any manner of the functioning of the institute.
Page 14 of 23
RULES & REGULATIONS
For College:-
- Students admitted to the Institute shall have to follow rules and regulations
given by the institution from time to time.
- Students will have to attend classes and practical hours regularly as per the INC
& State Nursing Council Norms.
- In case of illness, permission shall have to be obtained from the Principal/Class
Coordinator to remain absent from College/School.
- Original certificates will be retained in the office of the Principal, and the same
will be returned at the time of relieving.
- Students shall wear prescribed uniform while on duty and at College premises.
- When a student found guilty of breach of discipline/misconduct within or
outside the premises of the institution, the Principal/Director may act according
to nature and gravity of the offence-
a. Suspension
b. Expel such from the institute
c. Disqualify from entering examination
d. Rustication from the institute.
- College authorities, hostel in-charge & hospital will not be take any
responsibility, if student try to attempt or commit any kind of nuisance,
unnatural act, within or outside the College/Hostel premises.
- Mobile phones are strictly prohibited within the college/hospital premises.
- Ragging strictly prohibited in or outside the college campus.
For Hostel:
- All rules & regulations of the hostel are to be obeyed by students strictly.
- Clothes are only to be washed in bathrooms.
- Cooking is not permitted in rooms.
- Each student is responsible for the care of hostel property such as room
furniture provided for their use.
- Students are advised to keep their valuable things or cash under lock, in case of
missing any thing, hostel in-charge or college authority will not be responsible.
- The College authorities reserve the right to check the hostel periodically without
prior notice.
- Visitors will not be entertained inside the hostel rooms. All visitors are allowed
in visiting rooms only
- Permission to leave station will be granted by the Principal on receipt of a
written request from the students and same can be submitted to Hostel warden.
Page 15 of 23
Anti-Ragging
a) Regarding ragging UGC regulations on curbing the menace of ragging in
higher educational institution, 2009 in view of the direction of the
Honorable Supreme Court of India will be followed strictly.
b) At the time of admission every student as well as parents shall be required to
sign the affidavit in related to Anti-ragging regulations and submit to concerned
college authority.
Calendar Note:
Programme P.B.BSc (Nursing)- 2years GNM-3½ years
Last date of sending
application form with
prospectus by post
21/06/2014 up to 5 pm
Closing date to receive filled
application
28/06/2014 up to 5 pm
Date for Entrance Test Post Basic 06/07/2014,
Sunday
11:00 am-01:00 pm
GNM 13/07/2014,
Sunday
11:00 am-01:00 pm
website www.bmhrc.org
D.D Rs.500 by hand
Rs.550 by post
D.D in favour of Bhopal Memorial Hospital & Research Centre, payable
at Bhopal.
Postal Address Principal, Bhopal Nursing College, Bhopal Memorial
Hospital & Research Centre, Raisen By-pass Road,
Karond, Bhopal (MP). Pin 462038.
RAGGING IS STRICTLY PROHIBITED RAGGING IS STRICTLY PROHIBITED RAGGING IS STRICTLY PROHIBITED RAGGING IS STRICTLY PROHIBITED
WITHIN BMHRC CAMPUS &COLLEGE WITHIN BMHRC CAMPUS &COLLEGE WITHIN BMHRC CAMPUS &COLLEGE WITHIN BMHRC CAMPUS &COLLEGE
Page 16 of 23
Application form No.
BHOPAL NURSING COLLEGE & SCHOOL OF NURSING
Bhopal Memorial Hospital & Research Centre, Bhopal (Indian Council of Medical Research, Department of Health Research, Ministry of Health & Family Welfare, Govt of India).
Raisen Bypass Road, Karond, Bhopal – 462 038
Tel. No. 0755-2742279, 0755 – 2742212-16, Extn. 8803, 8821 (Recognized by : Indian Nursing Council & MP State Nursing Council & Affiliated to Barkatullah University, Bhopal (MP).
Application form for GNM Post Basic B.Sc. Nursing
(IN BLOCK LETTERS ONLY)
Student’s Name@N k= @N k=k d k u ke:
__________________________________________
Father/Husband Name@fir k@ifr d k u ke %____________________________________
Mother’s Name@ekr k d k u ke: _____________________________________________
Date of Birth@t U e fn u kad: ____/___/________ Age in years _____
Nationality@j k" V ªh;r k : __________________
Religion@/keZ : ________________ Caste/t kfr : __________________
Category@ oxZ : ST/SC/OBC/GEN
Present Address@LFkku h ; ir k: _______________________________________________
_____________________________________________________________________
_______________________________________Pin
____________________________.
Phone No. 1._______________________ 2. _______________________
Mobile No. 1._______________________ 2. _______________________
Permanent Address@L F kk;h ir k %____________________________________________
_____________________________________________________________________
_______________________________________ Pin __________________________.
Phone No. 1._______________________ 2. _______________________
Mobile No. 1._______________________ 2. _______________________
Self attested
Photograph
Page 17 of 23
Local Guardian (if any)@LF kkuh ; vfH kH kk od ¼; fn d ksbZ gks rks ½
Address @ ir k: ________________________________________________________
____________________________________________________________________
_______________________________________Pin __________________.
Phone No. 1._______________________ 2. _______________________
Mobile No. 1._______________________ 2. _______________________
Educational Qualification
For GNM
Examination Year of
Passing Board/University
Max
Marks
Marks
Obtained %
Number of
attempt
10th
12th
Others (if any)
For Post Basic B.Sc (N)
Examination Year of
Passing Board/University Max.Marks
Marks
Obtained %
Number of
attempt
10th
12th
GNM
3½ Years
Others (if any)
Register Nurse No: ------------------------- Register Midwife No :-----------------------
Registration council:---------------------------------------------
Place :--------------------------
Date of Registration :----------------------------
Signature of the candidate…................
Page 18 of 23
For office use only
Admission No
Signature of Faculty Course
Receipt No
Signature of the Principal Category GEN/SC/ST/OBC
Remark: All verified certificates are to be submitted in the office at the time of admission.
6 sets of below mentioned documents with attestation to be submitted by the selected
candidates along with original at the time of admission@v k o ’;d n Lrk ost , o a i z ek .k i = ¼5 i z f r;k sa @v k o ’;d n Lrk ost , o a i z ek .k i = ¼5 i z f r;k sa @v k o ’;d n Lrk ost , o a i z ek .k i = ¼5 i z f r;k sa @v k o ’;d n Lrk ost , o a i z ek .k i = ¼5 i z f r;k sa
e sa½e sa½e sa½e sa½
1. 10th pass Marksheet / 10oha d { kk d h v ad l wfp
2. (10+2) pass Marksheet / 12oha d { kk d h vad l w fp
3. GNM 1st, 2
nd, 3
rd & Internship Marksheet / t h,u,e iz F ke] f }R rh ;] r` rh; ,oa ba VuZ f’ ki d h v ad l wfp
4. GNM Diploma / f MI yksek t h ,u, e
5. State Nursing Council Registration / jkt d h; iat hd j.k ifj" kn l s iat hd j.k
6. Transfer certificate/Migration certificate/ LFkkuka rj.k iz ek.k i= v Fko k ekb xz s’k u
7. Caste Certificate / t kfr iz ek.k& i=
8. Income Certificate / vk; iz ek.k& i=
9. Domicile Certificate / ewyfuokl h iz ek.k& i=
10. Affidavit (in case of change of Name) / ’kiFk& i= ¼;f n uke esa d ksbZ i fjorZ u gks rks½
11. Recent Passport size photo – Colored (10) / ikl iksVZ vk d kj d s j ax hu Q ks Vks ¼10 ½
12. Recent Stamp size photo – Colored (4) / LVkE i vkd k j d s ja xhu Q k sVks ¼4½
13. Parents and Guardian’s photograph / ekrk& firk ,oa vfH kH kkod d s Q k sVk s
uksV % Points 3,4 and 5 is not applicable for those students, who are taking admission in GNM.
fcanq Ø ekad 3]4 ,oa 5 t h,u ,e esa iz os ’k y s jg s N k= @N k = kvksa d s fy ;s ugha gS A
All the documents should be attested by a Gazetted officer of India.
l eLr vfH k ys[ k @nLr kost + jk t if= r v f/kd kjh }kj k vfH kiz ekf.k r gk suk pkf g; sA
Page 19 of 23
BHOPAL NURSING COLLEGE & SCHOOL OF NURSING
Bhopal Memorial Hospital & Research Centre, Bhopal (Indian Council of Medical Research, Department of Health Research, Ministry of Health & Family Welfare, Govt of India).
Raisen Bypass Road, Karond, Bhopal – 462 038
Tel. No. 0755-2742279, 0755 – 2742212-16, Extn. 8803, 8821
(Recognized by : Indian Nursing Council & MP State Nursing Council & Affiliated to Barkatullah University, Bhopal (MP).
MEDICAL EXAMINATION FORM
Student Name _____________________________
Age :____________ Sex : _________
Previous history of any illness : ___________________________________________.
Any Treatment Taken : ___________________________.
Weight : ____________ Height : _________________ Vital Signs : __________
LABORATORY INVESTIGATIONS
1. CBP with ESR :
2. Blood Group & Rh : __________________________________
3. Urine RE : __________________________________
4. HBsAg : __________________________________
5. X-ray Chest PA view : __________________________________
6. ECG : __________________________________
7. Vision : __________________________________
8. Any deformity : ___________________________________________
9. Any other observation after examination by the CMO ______________
Inferences:
Mr/Ms/Mrs _____________________________________________ is examined on
_____________ and found to be medically __________________ (Fit/ unfit).
Name & Signature of the CMO with Reg. No: ______________________________
Stamp:
Place:
Date:
Note : The Medical certificate should be obtained from Govt. Medical Officer.
Page 20 of 23
ANNEXURE-I
AFFIDAVIT BY THE STUDENT I,______________________(fullname of student with admission registration/enrolment
member) s/o, d/o, Mr./Mrs./Ms.___________________ having been admitted to (name of the
institution) _________________________ have received a copy of the UGC Regulations on
Curbing the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called
the “Regulations”) carefully read and fully understood the provisions contained in the said
Regulations.
2) I have, in particular, perused clause 3 of the Regulations and am aware as to what
constitutes ragging.
3) I have also, in particular, presued clause 7 and clause 9.1 of the Regulations and am fully
aware of the penal and administrative action that is liable to be taken against me in case I am
found guilty of or abetting ragging, actively or passively, or being part of a conspiracy to
promote ragging.
4) I hereby solemnly affirm and undertake that:
a) I will not indulge in any behavior or act that may be constituted as ragging under clause 3
of the Regulations.
b) I will not participate in or abet or propagate through any act of commission or omission that
may be constituted as ragging under clause 3 of the Regulations.
5) I hereby affirm that, if found guilty of ragging, I am liable for punishment according to
clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken
against me under any penal law or any law for the time being in force.
6) I hereby declare that I have not been expelled or debarred from admission in any institution
in the country on account of being found guilty of, abetting or being part of a conspiracy to
promote, ragging; and further affirm that, in case the declaration is found to be untrue, I am
aware that my admission is liable to be cancelled.
Declared this________day of________month of ________year.
Signature of deponent
Name:
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of
the affidavit is false and nothing has been concealed or misstated therein.
Verified__ (place) __on this the__ (day) _of __(month), __(year)____
_________________
Signature of deponent
Solemnly affirmed and signed in my presence on this the (dav) ___ of (month), ___ (year:)
___ after reading the contents of this affidavit.
Signature of Notary
Page 21 of 23
ANNEXURE-II
AFFIDAVIT BY PARENT/GUARDIAN
I, Mr./Mrs./Ms._________________________________(full name of parent/guardian)
father/mother/guarding of, (full name of student with admission/registration/enrollment
number) having been admitted to (name of the institution)___________________ have
received a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher
Educational Institutions. 2009, (herein after called the Regulations”) carefully read and fully
understood the provisions contained in the said Regulations.
2) I have, in ,particular, perused clause 3 of the Regulations and am aware as to what
constitutes ragging.
3) I have also. In particular, presued clause 7 and clause 9.1 of the Regulations and am fully
aware of the penal and administrative action that is liable to be taken against my ward ,in case
he/she is found quality of or abetting ragging, actively or passively, or being part of a
conspiracy to promote ragging.
4) I hereby solemnly aver and undertake that :
a) My ward not indulge in any behavior or act that may be constituted as ragging
under clause 3 of the Regulations.
b) My ward will not participate in or abet or propagate through any act of commission
or omission that may be constituted as ragging under clause 3 of the Regulations.
5) I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according
to clause 9.1 of the Regulations. Without prejudice to any other criminal action that may be
taken against me under any penal law or any law for the time being in force.
6) I hereby declare that my ward has not been expelled or debarred from admission in any
institution in the country on account of being found guilty of, abetting or being part of a
conspiracy to promote, ragging; and further affirm that, in case the declaration is found to be
untrue, I am aware that my son/daughter admission is liable to be cancelled.
Declared this _____day _________ of month of ____ year.
________________
Signature of deponent
Name :
Address :
Telephone/Mobile No:
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of
the affidavit is false and nothing has been concealed or misstated therein. Verified__ (place)
__on this the__ (day) _of __(month), __(year)____
_________________
Signature of deponent
Solemnly affirmed and signed in my presence on this the (day) _of __(month),
__(year)____after reading the contents of this affidavit.
Signature of Notary
uk sV %uk sV %uk sV %uk sV % Annexure-I and II to be submitted at the time of admission only
. , usDT k +j 1 ,o a 2 iz os’k d s l e; t ek d juk v f uok ;Z g S A
Page 22 of 23
BHOPAL NURSING COLLEGE & SCHOOL OF NURSING
Bhopal Memorial Hospital & Research Centre, Bhopal (Indian Council of Medical Research, Department of Health Research, Ministry of Health & Family Welfare, Govt. of India).
Raisen Bypass Road, Karond, Bhopal – 462 038 Tel. No. 0755 – 2742212-160, 0755-2742279 Extn. 8803, 8821
(Recognized by : Indian Nursing Council & MP State Nursing Council & Affiliated to Barkatullah University, Bhopal (MP).
Admission for Girls Hostel Accommodation
To
The Principal
Bhopal Nursing College & School of Nursing
BMHRC
Bhopal.
Subject: Seeking for Hostel accommodation in Girls Hostel, BMHRC, Bhopal.
I wish to reside in the Girls Hostel, BMHRC, Bhopal, kindly provide accommodation with
effect from ______________.
I solemnly declare that during my stay in hostel, I will abide the rules and regulation of the
College hostel and as modified thereafter, or from time to time. Competent authority can take
any disciplinary action; if I fail to abide rules and regulations of the hostel.
Name & Signature of the Student Name & Signature of the parent
Permanent Address Local Guardian if any Name & Address
Note: Submit Parents or Local Guardian photograph with application form.
___________________________________________________________________________
For office use only
Hostel accommodation is _________________________(allotted or not allotted) to -----------
---------------------------------(Name of the student) with effect from __________________ in
Girls hostel, BMHRC,Bhopal.
Signature of the Hostel Warden Signature of Principal
Self
attested
Student
photo
Page 23 of 23
DECLARATION
I _________________________________________D/o/S/o __________ _______
____________________ do hereby solemnly affirm and declare that:
- Information provided by me in the application form is correct and to the best of my
knowledge and belief and nothing has been concealed.
- I shall fully abide by the orders, rules and regulations of the College/School as stated
in prospectus.
- I shall not violate the rules of the College/School by taking part in any kind of strike or
such other activities harmful to the College/School. If I do so, my name should be
removed from the College/School.
- I admit that any charges/fees paid to the College/School will neither be refundable nor
transferable, whatsoever may be the reason.
- In case, I leave the College/School before the completion of the course, I shall be
liable for the payment of all dues of the College/School.
- I will attend regular classes; participate in College/School activities and self
development programmes.
- I will fulfil the required theory and clinical hours, prescribed by Indian Nursing
Council. I shall participate in co-curricular and extra-curricular activities.
Name & Signature of the candidate
Place:
Date :
This is to certify that I parent/Guardian shall be responsible for regular payment of fees
and other dues, good conduct and welfare of (name of student) ______________
_______________________ during her/his studies in Bhopal Nursing College/Bhopal
School of Nursing.
Name & Signature of the Parent/Guardian
Place:
Date :
