Admission for B.Sc.Nursing

HSC Registration No * *

Name * * Father's Name * *

Date Of Birth *

Gender * Male Female Transgender

Religion * Hindu Christian Muslim Others

Community * OC BC MBC / DNC SC ST

Permanent Address * * City * * E-mail

Contact Number 1 * *

Contact Number 2 *

Name of the Qualifying Examination * Marks obtained (%) HSC

Physics * *

Chemistry * *

Biology *

Botany *

Zoology *

English * *

Total * *

Reg No/Roll No. Month and Year of passing the qualifying examination. * Name of the Board/ University from which the qualifying examination passed. * Medium of instruction * Tamil English Others Name & full address of the College/School last attended. *