PROFORMA FOR UNDERTAIKNG IN THE FORM OF AFFIDAVIT

UNDERTAKING

I, Dr. .

S/o / D/o, bearing PG NEET 2017 Rank

No .. and Hall Ticket No. give undertaking as

below, in connection with my claim under Area Status (Study certificates/Residence certificate)

and Caste Category for admission into PG Medical Degree/ Diploma and MDS Courses for the

Academic Year 2017-18 in Colleges under KNR University of Health Sciences.

I am aware that the relevant certificate (s) is / are found to be not genuine at a later date,

I forego the seat allotted in my favour. Further I agree that I abide the Rules and Regulations of

KNR University of Health Sciences and I am liable for criminal prosecution, as may be deemed

fit.

I also hereby undertake that I shall not enter into legal litigation, if the seat allotted to me

is cancelled, for the above reasons.

Signature of the Parent / Guardian Sgnature of the Candidate

Aadhar No.

Name:

Address :
Aadhar No.

Place: .

Date: