Student Apply

Student Name

Father Name

Mothers Name

Husband Name

Applicents Age

Date of Birth

Address

Dist

Taluka

Pincode

Cellno

Wats no

Email ID

Nationality

State

Aadhaar No

Cast

(ST/SC/OBC/Other)Subcast

Education Qualifications

S.NO	COUSE	STREAM	PASSING YEAR	RESULT (%)
1	S.S.C(S.S.L.C)
2	H.S.C(+1. PUC)
3	A.N.M
4	G.N.M

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I herby state I have filled this form myself and the best of my knowledge and belief, the particulars given are true. Also I, hereby undertake that I shall by the rules and regulation of institution shall pay the fees regularly and shall not behave unworthily as student of this institution.

Contact Address :

Sri Uma Maheshwara School of Nursing

Balaji Nivas Shakti Nagar, Shahbad Road, Kalburgi (Gulbarga) - Karnataka India.

Addmistrative Office

R.N Jadhav Plot No-26, Chamundeshwari Nagar, Santosh Colony, Undoor Road, Kalburgi (Gulbarga) - 285103, Karnataka India.