1.

DOCUMENT VERIFICATION

ANNEXURE A

Please meet the Deputy Registrar (Academic) with the following documents in original together with one attested copy each to complete the admission formalities on the date of reporting. a) Matriculation or SSLC Certificate in original for verification of date of birth b) Marks cards in original for all examinations from SSLC/Matriculation onwards. c) Degree certificate of the qualifying examination. Candidates for Research programme should complete all the requirements for the award of their qualifying degree including dissertation, project, viva-voce, etc. by 14th August 2011. At the time of admission they should produce all the Marks Sheets and degree/provisional degree certificate issued by the head of the Institution/University Authority. Such candidates will be given regular admission. e) If you have completed your course programme but are yet to receive the marks cards/degree certificate of your qualifying examination, you should produce at the time of admission, a provisional certificate from the University Registrar or Controller of Examination stating that you have completed all the requirements for the award of the degree, including dissertation/project report/viva voce etc. as applicable. Till this condition is fulfilled, your admission will remain on a provisional basis. However you should produce the final degree certificate/marks card on or before 31st October 2011. f) Two passport size coloured photographs for issue of identity card. g) If you belong to OBC category and in non creamy layer, you should produce the original OBC Certificate recently issued by the competant authority.

d)

2. EMPLOYED CANDIDATES : In case you are employed in a government, quasi government or government-aided institution, or similar institution in public/private undertaking etc. you must produce a No Objection Certificate from your employer at the time of joining. 3. MEDICAL REQUIREMENTS : Your admission is subject to your being declared physically fit by the Institute Medical Officer for undertaking the course. The proforma of Medical Examination and Certificate, given beklow, has to be filled and signed by an authorised Medical Officer and presented to the Chief Medical Officer of the Institute for his scrutiny, when you meet him on being admitted to the Institute. 4. DECLARATION BY PARENT/ GUARDIAN : You must fill in the Declaration by Parent/Guardian form given below, at the time of reporting.

STUDENTS MEDICAL EXAMINATION FORM

(To be produced at the time of reporting)

This form must be filled and signed by a Registered Medical Officer recognised by the State Medical Council.

Name Gender Date of birth Relevant past history Relevant family history Height in cms Weight in Kgs B.P. Chest expansion Vision (including color) General examination Cardio-vascular system Respiratory system Abdomen Hernia/hydrocele Nervous system Any other findings Urine analysis

ALBUMIN SUGAR SP.GR. MICROSCOPY

Blood group and Rh Identification mark CERTIFICATE Dr.______________________________________ hereby certifies that the candidate whose signature is given below was examined by me and is found to be physically and mentally fit to undergo Research Programme. He/She requires/ does not require any medication/follow-up. Signature of the candidate Signature of the Authorised Medical Officer Seal: For Office Use only S.R. NO. Date of admission Department Program

DECLARATION BY PARENT/ GUARDIAN (To be produced at the time of reporting)

Name of the Student Fathers Name Mothers name Guardians name

(in case parents are not there)

___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________

Annual Income
(including all sources)

Permanent Address of parents

Telephone No. with STD code: Mobile No:

_____________________ _____________________

In the event of Mr/Miss/Mrs. ______________________________________________________ being admitted to the Institute, I shall be responsible for his/her conduct conducive to the academic activities of the Institute, as well as support at the Institute.

Place: Date :

Signature of the Parent/Guardian Name: