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.
Sri Uma Maheshwara School of Nursing
Balaji Nivas Shakti Nagar, Shahbad Road, Kalburgi (Gulbarga) - Karnataka India.
R.N Jadhav Plot No-26, Chamundeshwari Nagar, Santosh Colony, Undoor Road, Kalburgi (Gulbarga) - 285103, Karnataka India.