1

PROSPECTUS

FOR

ADMISSION INTO

GENERAL NURSING & MIDWIFERY (G.N.M) COURSE

IN GOVERNMENT

&

PRIVATEINC RECOGNISED

TRAINING SCHOOLS OF ODISHA

DURING THE ACADEMIC SESSION 2015–16

Cost of Application Form & Prospectus: Rs.500/- (Rupees Three Hundred) only

2

Application form & Prospectus for admission into GNM training course for the academic

session 2015-16 are available in the official website of Directorate of Nursing, Odisha&

DMET ,Odisha “www.nursingodisha.nic.in” & “www.dmetodisha.gov.in”. Intending male

and female candidates may apply online by depositing prescribed fee Rs. 500/-(Rupees Five

Hundred only) in shape of SBI Challan attached in the prospectus (annexure-3).The candidate

may avail the facility for submission of On-line application which are available at the nearest

center i.e. CSC (Common Service Centre), at Gram panchayat level/Community Health Centre at

block level/CDMO office at District level.

For any query contact:- 0674-2393840

3

Index

Sl.no Content Pa ge no

I Admission Calendar 5

II General Information & Eligibility 6

III Admission Procedure 7-15

Online registration

Online Choice Filling

Provisional Merit List, Document Verification & Choice

Locking

Provisional Seat Allotment (Round 1)

Deposition of Course Fees

Final Seat Allotment (Round 2)

List of Left Out Candidate

IV Post Admission 16-17

V Selection Committee 18

Annexure I List of Institution participating in Counseling 19- 23

Annexure II SBI challan for Application Fee 24

Annexure III List of Nodal Centers 25

Annexure IV Cast Certificate Proforma 26

Annexure V Residence/Nativity Certificate Proforma 27

Annexure VI Proforma of Certificate of Sainik Board 28

Annexure VII Proforma for undertaking by guardian 29

Annexure VIII Proforma of physical fitness certificate. 30

4

PREFACE

Nursing is a rewarding career that offers a bright and satisfying future for young

persons who have a desire to serve people with a caring attitude. As members of a modern

health care team, nurses render a significant service in the care of the sick and in the prevention

of illness and injury. Increasing numbers of trained nurses are needed to fill responsible

positions as experts in bedside nursing services, and as researchers seeking new and better

ways of meeting the nursing needs of patients. Salary and conditions of service of nurses are

attractive compared to those in other fields of employment with similar educational requirements.

Nursing offers a challenge and opportunity to serve a fellow being. If you have the zeal and

desire for nursing, you are invited to choose this noble profession.

In order to facilitate the admission at door step in remote areas and to bring clarity in the

selection process, Govt. of Odisha have introduced submission of online application,

selection & admission into GNM course at G.P level which is praiseworthy.

5

ADMISSION CALENDAR

Publication of Advertisement 13.07.2015

Availability of Online Application form and

Prospectus in official website

www.nursingodisha.nic.in/www.dmetorrisa.gov.in/

www.nrhmorissa.gov.in/odisha.gov.in/

14.07.2015 to 12.08.2015. ( The Mock registration process starts from 14.07.2015 to 16.07.2015 till 2.00 PM after that 17.07.15 11.00 AM) onwards the final registration process will start.)

Last date for submission of application 12.08.2015 by 05.00 P.M

Expected date of Publication of provisional merit

list in the official website:

www.nursingodisha.nic.in/www.dmetorrisa.gov.in/

www.nrhmorissa.gov.in/odisha.gov.in/

20.08.2015

Expected date of Document Verification and choice

locking at Nodal Centres

25.08.2015 to 27.08.2015

Expected date of Reporting at nodal centers with

course fees.

02.09.2015 to 04.09.2015

Final seat allotment 10.09.2015

Reporting at nodal center With fees for 2nd

round

counseling 15.09.2015 to 16.09.2015

Publication of list of left out Candidate 21.09.2015

6

I. GENERAL INFORMATION

- Applications are invited for admission in General Nursing & Midwifery (GNM) 1training course in

all Government & INC approved Private G.N.M training centers for the year 2015-16 (detail list of

institutions can be found in annexure 1).

- The duration of the training course is 3 years which includes theory and practical as per

prescribed syllabus of Indian Nursing Council.

- Admission for all seats in government institutions & 85% of seats in private institutions

will be filled up through common merit list.

- Private Institutes will adopt their own procedure for filling up 15% seats under

management quota.

- All the institutions (Govt. & Private) having INC recognition as on 31.07.2015 will be

allowed for the e-counseling process.

III. ELIGIBILITY

- Candidate must be 17 years of age or above as on 31. 12. 2015.

- There is no age bar for registered ANM/LHV candidate.

- The candidates must have passed

10+2 with 40% marks from CHSE Odisha or equivalent thereof however science is

preferable.

Or

10 +2/12th

with 40% marks from state open schools recognized by state Govt. and

National Institute of Open School recognized by Central Govt.

Or

10+2 vocational ANM course with 40% marks from the school recognized by Indian

Nursing School.

Or

10 +2 Health Science vocational stream from a recognized CBSE Board/ State/ Center.

- 5% of total mark is relaxed for SC/ ST candidates.

- Must have passed Odia up to M.E. standard for the candidate seeking admission in Govt.

School of Nursing & against 85% Govt. quota of Private School of recognized by INC.

- Must be a domicile / permanent resident / native of Odisha but currently residing outside

Odisha.

7

- Both female / male candidates (10% reservation for male candidates out of total seats)

are eligible to apply.

- Physically Handicapped having locomotor disability of lower limbs between 40% to

50% will be taken in to consideration. Candidates are advised to obtain their physical

handicap certificate from the competent medical authority of their district on last week of

july 2015 or first week of august 2015.

- Shall be medically fit for the course (Medical certificate format in annexure -VIII)

III. ADMISSION PROCEDURE

- Candidates can apply for the GNM Course online by applying in the appropriate

application form available at website: www.nursingodisha.nic.in/www.dmetorissa.gov.in on

or before 12.08.2015 by 05.00 PM.

8

The e-counseling and admission Process involves the following steps:

Step 7

•Left out candidate list is prepared, verified and displayed on the website.

Step 6

•Round – 2: Seats not filled up in Round 1, will be filled up in the Round 2 as per the merit list.

Step 5

•The Candidates who have been allotted seats will come to the Nodal Centre and deposit course fees. The candidate who does not deposit course fee within stipulated time period her/his allotted seat will be cancelled and such candidates will be deleted from the merit list.

Step 4

•Round – 1: Provisional Seat Allotment & publication on the website.

Step 3

•Provisional Merit List. Document Verification at Nodal Centres. The copy of the Candidate Details, Document Details and Choice list will be generated and signed by both Nodal Officer and Candidate.

Step 2

•Choice Filling by the Registered Candidates

Step 1

•Payment of application fee & online form fill up by the candidate and registration for User id and Password.

9

Step 1: Online Registration

Procedure for online Registration

Payment of Non-refundable Application fees Rs. 500 only through S.B.I.Challan.

The amount is payable through SBI Challan ( given in the annexure II)

Open the website www.nursingodishanic.in

Click on "New Registration for ANM and GNM courses”

and andand aaaandannanand AAANMANM....................

Click "apply online" and then click on "GNM".The online application form will be displayed.

Fill the details on the application form and click on save and continue.

Then the candidate will be directed to generate his /her own password.

ASSISTANCE:

Note: Candidate may practise with the mock application form available in the

official website www.nursingodisha.nic.in (link) before filling up the actual

application form.

The candidates finding difficult to register online can get the assistance of the

Govt. facilities like CDMO(DPMU Office), Community Health Centre(CHC) &

Common Service Center (CSC) at Gram Panchayat level .Service charges Rs. 25/-

only is to be paid towards filling up form at Common Service Center.

10

Filling up online Application form

After login, the candidate has to fill up the following details in the form.

Personal Details, Address Details, Academic details, Challan details,

Colour Photo (20- 50 KB in jpg/jpeg) & Signature (10-20 KB in jpg/jpeg)

Snapshot of the online form given below

11

Step 2: Online Choice Filling

- Candidate must verify the name of the list of the institutions & total no. of seats available (Annexure-

I) & fill up the choices for institutions.

- The candidate can give his/her choices judiciously in order of preference from the list of

available institutions as per own wish. The candidates are advised to see the updated list of

institutions till 31.07.2015 for choice filling up for the institutions.

- The candidates are permitted, if they so desire, to change or re-order (through move/swap

options) their choices, delete earlier choices and add new choices as many times til they lock

their final choices at the nodal center during document verification.

Step 3: Provisional Merit List, Document verification & Final Choice Locking

a. Provisional Merit List

- Merit list shall be prepared on the basis of career marks.

- For calculating career marks, 50% of the percentage of marks secured in HSC (10th

or

equivalent examination without extra optional) and 50% of the percentage of marks secured

in CHSE (10+2 or equivalent examination without extra optional.) will be taken into

consideration.

- Preferences will be given as follows:-

1. 10+2 Science with Biology.

2. 10+2 Science without Biology.

3. 10+2 and other equivalent examination.

Important Note:

Before choice filling in the final application form candidate may practise the mock

format available in the official website www.nursingodisha.nic.in (link).

Important Note:

. The candidate is required to verify his/her personal details before submission of application

as per documentary evidence.

. The selection committee is not responsible for any omission & commission in the

submitted datas and the consequences thereafter.

. In case of discrepancies if any, the candidate may bring it to the notice of the Principal

Tutor of the Concerned Nodal Centre during the time of document verification.

. Help centers like (CSC, CHC, CDMO) Office will hand over a copy of the submitted

application form (duly signed both by the candidate & officer in-charge of the center) to the

candidate & retain the second copy for the official record.

12

- In case of more than one candidate having equal career marks, inter-se merit shall be

taken into consideration as below in order of preference.

a. Qualifying stream .

b. English marks in 10+2.

c. Seniority in date of birth.

b. Reporting at Nodal Centre for Document Verification

- Provisionally selected candidates are required to attend the designated nodal center

(annexure III) for verification of original relevant documents, payment of course fees and

choice locking on the scheduled date and time notified on the official web-site.

- During document verification at the nodal centers the candidates are required to submit

two sets of the following documents (one set original, other set self-attested photo copy).

The nodal center has to return back the original documents to the candidate after due

verification.

Documents required for verification are as follows:

1. Copy of the submitted application form duly signed by the candidate or a copy

received from the help center.

2. Original 10th

(HSC) pass certificate issued by BSE Odisha or equivalent thereof.

3. 10+2 pass certificate issued by CHSE Odisha or equivalent thereof.

4. Original College Leaving Certificate / Transfer Certificate

5. Original character /conduct certificate from the Head of the Institution last attended

6. Domicile/ Residential / Nativity Certificate from competent authority as per

Annexure-v

7. Authentic proof of passing Odiya as a subject at M.E/HSC issued by Board of

secondary education (for candidates applying for Govt. Institutions & 85% of

Govt. quota seats of Private Institutions.)

8. Original caste certificate (SC/ST candidate) issued by the competent authority.

(Annexure iv)

9. Original Physically Handicapped certificate issued by the competent medical

authority of the Dist. (in case of Physically Handicapped candidates only).

Locomotor disability of lower limbs between 40% to 50% will be taken into

consideration.

10. Original SBI Challan deposit slip, Rs.500/-(Rupees Five Hundred) only towards

application fees.

11. Two copy of self-attested recent passport size Colour photograph.

12. Original certificate of Ex-Serviceman from Rajya Sainik Board (Annexure vi)

13

13. Original Green Card (with all pages) issued by the Chief District Medical

Officer. (In case of candidate claiming for the seat under green card quota).

• In case of any discrepancy(from HSC /equivalent certificate) in the green

card the candidate shall have to submit an affidavit duly sworn before the

executive magistrate failing which the Green Card reservation quota will not

be taken in to consideration

14. The original Medical Fitness certificate issued by the Govt. medical officer.

If a candidate fails to submit the original College leaving certificate

(C.L.C/ T.C) or character /conduct certificate at the time of document

verification, he/she may be admitted with an undertaking to submit the same

before the Principal Tutor of the concerned GNMTC.

Note: In case the candidate fails to produce any original document as per the prospectus,

his/her name will be deleted from the list.

C. Final Locking of Choices

- Candidate has to lock the choice as per her/his own preference at the nodal

centers immediately after verification of original documents and testimonials.

- Candidates are advised to give maximum numbers of choices in order of preference.

- The nodal centers have to handover a print out of final locked choices signed both

by the candidate and officer in charge of the nodal center.

Step 4: Provisional Seat Allotment (Round 1)

- During this step, the seats will be allotted in the order of final merit list prepared

after the document verification and choice locking at the nodal center.

- The provisional allotment of seats will be available on the official

website www.nursingodisha.nic.in and SMS alert regarding allotment will be sent to

candidates.

Steps 5: Deposition of Course Fees at Nodal Centre

Candidate has to deposit the following fees at the nodal centre towards course fees in shape of

DD in favour of “the Convener GNM selection committee payable at Bhubaneswar”

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Fees for Government institutions

Sr.No Title of the fees 1st

Year 2nd

Year s3rd

Year

1 Admission Fees Rs.2250/- Rs.2250/- Rs.2250/-

2 Tuition Fees Rs.2250/- Rs.2250/- Rs.2250/-

3 Hostel Fees Rs.1800/- Rs.1800/- Rs.1800/-

4 Electricity Charges Rs.900/- Rs.900/- Rs.900/-

5 Transportation charges for field training

Rs.650/- Rs.800/- Rs.800/-

6 Identity Card Rs.150/-(once) _ _

7 Caution Money (Refundable) Rs.1000/-

TOTAL Rs.9000/- Rs.8000/- Rs.8000/-

Besides the above the messing charge may be charged extra.

Fees for 85% Govt. quota seats under Private institutions

1 Tuition Fees (including fees towards hospital for Clinical Training)

Rs.36,000/- per annum

Total Rs.36,000/-

NB:- Charges for Lodging, Boarding, Transportation, etc. shall be paid separately.

If the candidate fails to deposit the requisite fees at the nodal centre on the notified date the

name of the candidate will be deleted from the counseling process.

Step 6: Final Seat Allotment (Round 2)

- The final allotment of seats after auto up gradation will be available on the official website

www.nursingodisha.nic.in and SMS alert regarding allotment will be sent to candidates.

- Candidate has to verify the reporting date for admission from the web-side

- Candidate has to report at the institution along with a copy of final seat allotment on the

scheduled date and time notified on the web-side.

- In addition to the documents already submitted at nodal center, an undertaking from a Local

Guardian as per Annexure –VII, should be signed by the Parent / Guardian of the candidate.

- Any candidate who had previously got a seat in private institution in provisional seat

allotment and after auto up-gradation get a seat in the Govt. Institution then, the balance

course fee will be refunded.

15

Reservation of Seats (from total seats) as per Orissa Reservation of Vacancies Act:

i) 22.5% for ST,

ii) 16.25% for SC.

iii) 3% for Physically challenged

iv) 3% for Ex-servicemen

v) 5% for Green card

- 10% s ea t s o f ( t o t a l n o . o f s ea t s av a i l ab l e i n Go v t . & IN C reco gn ized

P r i v a t e i n s t i t u t i on s ) wi l l b e r es e r ved fo r m al e cand id a t e .

- In case of non-availability of candidates belonging to Scheduled Caste community,

Scheduled Tribe, candidates can be selected in their place and vice versa subject to other

eligibility criteria.

- In case of non-availability of candidates in any of the reserved category, the seats will be

filled up from the candidate of unreserved category.

- If any seats out the 85% govt. quota seats of the private institution remains vacant, then the

private institutions may be allowed to fill up those seats from the common merit list.

Step 7: List of Left out Candidates

- In this step list of candidates, who has not been allotted the seat even after completion of

seat allotment process will be prepared.

- List will be verified and displayed on the website: www.nursingodisha.nic.in

- The process of counseling of the left out candidates will be notified in the official

website.

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IV. POST ADMISSION

A Hostel Accommodation

- There is provision for accommodation in the G.N.M. Training Centre only for female candidates.

No provision of hostel accommodation for male candidates.

- Candidate may reside outside the hostel if permitted by the Director Nursing Odisha , only in

exceptional circumstances.

- The candidates are to abide by the Rules and Regulations of the concerned Institutions and

Hostel, during the period of study.

- If any of them will be found to be involved in immoral activities, unruly and undisciplined

conduct, she/he will be liable for due punishment by the concerned Principal Tutor under

intimation to the Director of Nursing, Odisha , Bhubaneswar.

B. Uniform

Selected candidates after admission have to wear uniform:

- Female candidate during clinical duty - white salwar kameez with white apron with black shoes

and during field practice - Green saree / salwar kameez.

- For male candidates, white shirt and white full pant with white apron and white socks with

black shoes during ward duty and green shirt and black pant during field duty.

C. Stipend

- As per decision of Government the students those who will get admission into Government

GNM Training Schools will get a stipend of Rs. 1000/- per month.

- On admission in the Training Centre N.T.I., SAIL, Rourkela, School of Nursing, NSC

Hospital, MCL, Talcher, SON IB Jharsuguda, stipend will be paid to students in each

month during the training period as per existing rules of the Government of Odisha.

- But the same will be paid only on successful completion of a preliminary examination after

three months of admission and after +2 Council & H.S.C Certificate/Mark list are found

genuine on verification and also after submission of necessary agreement by their Parents/

Guardians in a Cartridge paper to refund the stipend paid to her/him if she/he will discontinue

the training.

In case a candidate fails to qualify herself / himself in the 1st preliminary examination, she /

he may be given maximum two more chances failing which her/his admission will be

cancelled and she/he will be debarred from training. In case of discontinuance from study

on any ground the stipend already received, will be recovered in full as per the provisions

of the Agreement.

17

- S.C./S.T. candidates admitted into G.N.M Course in INC recognized Private Institutions

, scholarship will be borne by NHM, under “Swasthya Sebika Nijukti Yojana” (SSNY)

Scholarship Scheme as follows:

o Partial Scholarship as Tution Fees to SC/ST students belonging to Non-KBK

districts @ Rs.15,000/- per annum.

o Full scholarship as Tution Fees to SC/ST students belonging to KBK & KBK+

districts @ Rs.50,000/- per annum.

o Sponsored SC/ST students have to execute a bond with Government which will be

provided during admission subject to provision of funds by the appropriate

authority.

D. Vacation& Holidays

i. Annual Vacation- 30 Days (which can be divided)

ii. Sick Leave (10 days)

iii. Preparatory Leave (7 days)

E. Discipline

- Absence of a student beyond 15 days in addition to the prescribed leave will not be

allowed to rejoin again except in case of candidate admitted on health ground subject to

production of medical certificate from competent authority.

- The student should not indulge herself/himself in criminal offences. If found involved in

such activities, she/he will be removed from the Training and the stipend received by her

during training period will be recovered in one installment.

- If any incident of ragging comes to the notice of the authority, the concerned student shall be

given liberty to explain and if her/his explanation is not found satisfactory, the authority

would expel her from the institution.

- No application for change of Training Institution during the training period will be

entertained.

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V. SELECTION COMMITTEE.

The State Selection Committee shall consist of:-

1 Director Nursing, Odisha Chairperson

2 Joint Director, Nursing, Education Vice – Chairman

3 Joint Director, Nursing, Clinical Member

4 Deputy Director Nursing , Odisha Member

5 Asst. Director Nursing, Education Convener

6 Secretary, ON&MEB, Bhubaneswar Member

7 Registrar, ONMC, Bhubaneswar Member

The Nodal Selection Committee shall consist of:-

1 CDMO/Director Capital Hospital Chair Person

2 Principal Tutor Convener

3 Senior Tutor Member

4 Senior Tutor Member

5 District Public Health Nurse Convener

6 Matron / Asst.Marton /Nursing Sister Member (Nominated by CDMO)

Selection of GNM Training Course will be under the supervision of Chair-person

& Convener of the State Selection Committee.

All disputes pertaining to the selection and admission shall fall within the jurisdiction of

Bhubaneswar only. The convener of the selection committee shall be the legal person in

whose name the selection committee may sue or may be sued.

19

Annexure - I

List of Institution participating Online Counseling & Admission

Process List of Government Institutions

Sr.No Name of the institutions as per dt:30.06.2015 No.of Seats available

1

GNM School Of Nursing Government, Hospital

Dhenkanal, Orissa

50

2 GNM School Of Nursing Government Hospital

Kalahandi, Orissa

60

3 GNM School Of Nursing Government, Hospital,

Kandhamal, Orissa

50

4 GNM School Of Nursing Government, Hospital,

Sundargarh, Orissa

30

5 SCB Medical College Hospital Sch. Of Nsg. PO /

M - Cuttack , 753007 ,Orissa

100

6 V S S Medical College Hospital School Of

Nursing, Burla, Sambalpur 768010 ,Orissa

100

20

List of the Private Institutions

Sl.No

Name of the institutions as per dt:30.06.2015

No.of Seats

1 Anjaali College Of Nursing Studies At-Uttara

Chaka, P.O- KousalyagangaBhubaneswar, Distt-

Khurda, Orissa-751002,Orissa

40

2 Ashwini School Of Nursing At - AshwiniHospital

Sector -1, Cda Cuttack ,Orissa

40

3 Bhagabati School Of Nursing At/Po -Padmapur,

Saragan Via: Sunhat Balasore756002 ,Orissa

20

4 Bhava Institute Of Medical Science &Research

Plot -1480, I R C Village, NayapalliBhubaneswar-

751015, Orissa,Orissa

40

5 Bhubaneswar School Of Nursing At

94,Dharmavihar, Po/Via - KhandagiriDist -

Khurda, Odisha - 751030,Orissa

40

6 Biswanath Institute Of Medical TechnologyPlot

No 360/2692, Mahadev Nagar, Lane No1,

Jharapada Bhubaneswar, Dist - Khurda,Odisha-

751006,Orissa

20

7 Blue Wheel Institute Of Nursing Sciences At--

Chandpur, Po - Chandpur Via - Ranpur, Ps -

RanpurNayagarh ,Orissa

30

8 D R I E M S School Of Nursing At -Kairapari, Po - KotsahiTangi Cuttack754022 ,Orissa

60

9 General Nursing & Midwifery TrainingSchool

Central Hospital, B Valley, MahanadiCoalfiields

Ltd At Po BrajrajNagar,Jharsuguda, Odisha-

768216,Orissa

20

10 General Nursing And Midwifery TrainingSchool,

N S Ch., Talcher, At/ P O - Dera,Talcher, Pin-

759103 ,Orissa

30

11 Gopabandhu Institute Of Medical Sci. &Research

Vill - Madhabpur, Po -Mahakalabasta Via -

Athgarh Cuttack754029 ,Orissa

40

12 Hitech School Of Nursing Health Park,Pandara Po - G. G. P. Bhubaneswar751025 ,Orissa

60

13 I I M T School Of Nursing S 3 M 4,

ChhendColony, KalingaSundergarh

Rourkela769015 ,Orissa

20

14 JharsugudaGNM Training College At/Po-

JharsugudaJharsuguda,Orissa

40

21

15 Kalinga Institute Of Industrial Technology

(Deemed University Campus- V) ,A T/ P O: KI I

T Bhubaneswar - 751 024, Orissa

50

16 Kalinga Nursing School, Kalinga

HospitalLimited,

Chandrasekharpur,Bhubaneswar-751023,Orissa

60

17 KoshalaGNM Training School

Dhanupali,SambalpurDistSambalpur- 768005,

Orissa

20

18 Kuntala Devi School Of Nursing At/Po-Debatra

Colony, SamantaMargDist -Nayagarh, Orissa -

752069,Orissa

30

19 Kuntala Devi School Of Nursing New BusStand

Road, Po KhurdaKhurda, Orissa752055 ,Orissa

40

20 Lord Jagannath Mission's School OfNursing Plot

No. 228/237, Sector - A, Zone -B

MancheswarIndl Estate, P O -

RasulgarhBhubaneswar 751010 ,Orissa

60

21 Maa Annapurna School Of Nursing Plot

No.2764/4805,

NageswarTangiBhubaneswarKhurda 751002

,Orissa

30

22 Mahima School Of Nursing At- GopalsagarP.O-

JagatsinghpurJagatsinghpur 754103,Orissa

20

23 Manjari Devi School Of Nursing, 208,Kharavela

Nagar, Unit-3,Bhubaneswar-751001,

KhurdahDistt.,Orissa

40

24 Mothers Nursing School Plot No 120 B,Kaling

Nagar, K - 1, GhatikiaBhubaneswar,Khurda,

Odisha751003 ,Orissa

40

25 National Institute Of Medical &Management

Studies 392-A/B, BaramundaKhurda,

Bhubaneswar - 751003,Orissa

40

26 Neelachal Institute Of Nursing School Co-

Housing Complex, Unit Iii KharvelNagar,Janpath

- KhordhaKhordha 751001,,Orissa

20

27 Netaji School Of Nursing Plot No. 262

(B),District Centre

ChandrasekharpurKhurdaBhubaneswar 751016

,Orissa

20

28 Nurses Training Institute IspatGeneralHospital

Rourkela, Sector-19 Sundergarh769005 ,Orissa

40

29 Orissa Nursing Training Institute PensionLane,

Buxi Bazar Dist Cuttack- 753001,Orissa,Orissa

20

22

30 Pallichandan School Of Nursing At/PoNimapara

(Women's College Road) Dist -Puri, Orissa-

752106,Orissa

30

31 PathaniSamanta Nursing Centre At- OldTown,

KaransahiDistNayagarh, Orissa

30

32 Prativa Devi School Of Nursing Plot No

79,Kharvel Nagar, Unit - Iii Bhubaneswar,Orissa -

751001,Orissa

40

33 Ramadevi School Of Nursing Pattamundai (By

Pass Chak) Kendrapara DistrictKendrapara-

754215, Orissa,Orissa

40

34 S I E M S School Of Nursing Plot No

467,Madhusudan Nagar, Side Of New A

GColonyDist Bhubaneswar- 751012, Orissa

30

35 Sabarmati School Of Nursing At MahanadiVihar,

Po NayabazarDist Cuttack- 753004,Orissa,Orissa

40

36 Sahayoga Institute Of GNM Training CollegeAt -

Kasturi Nagar, 5th Lane, Po/Dist -

RayagadaRayagada 765001 ,Orissa

30

37 Sailabala School Of Nursing AtSailashrinibas,

Narendrakona, Po PuriTownPuri, Odisha-

752001,Orissa

30

38 Salandi School Of Nursing Nh - 5, MotelSquare

Tehsil - BhadrakBhadrak 756100,Orissa

20

39 Sambalpur Nursing School At- Govindtola,Po-

Dhanupali, Sambalpur 768005 ,Orissa

30

40 Sarada Devi Institute Of Medical Science #1525,

Mahanadi Vihar Cuttack 753004,Orissa

40

41 School Of Nursing & Health Sciences, HillPatna,

Behrampur-760005,Orissa

40

42 Seva School Of Nursing At - IndrahaniNagar Po -

Turanga, Angul-759123, Orissa,

30

43 Shaikh School Of Nursing

BaghraRoad,NearPrativa Nursing Home Ward

No-16,Baripada, Mayurbhanj, Orissa, Pin-

757001,Orissa

30

44 Shree Mahavir School Of Nursing,Gopalpur,

Cuttack-753 010,Orissa

40

45 SmtSusila Devi Institute Of

NursingEducationSaiPriya Nagar, Near

NyrSchoolRayagadaRayagada 765001 ,Orissa

30

46 Sri Jagannath School Of Nursing C/O MrMukesh

Kumar Vasani, At Post KhariarRoadNuapada,

Odisha- 766105,Orissa

30

23

47 Sum Nursing School, C-51, B D A H I GDuplex,

Baramunda, Bhubaneshwar-751003,Orissa

75

48 SundergarhGNM Training College

AtSankaraSundargarh 770001 ,Orissa

35

49 Surya School Of Nursing At/Po - Hatadihi,Dist -

Kenojhar Kenojhar-758082, Orissa

30

50 Sushree Institute Of Technical Education ASchool

Of Nursing, PallishreeVihar, At/ Po-Sadaipali,

DistBalangir, Orissa-767065

40

51 Susila Devi Batakrishna Nursing School,Door No-

866/1379, Street: Rajpur,Nuapada, At/ Po/ Dist-

Nuapada-766105,Orissa,Orissa

40

52 Tulasi G N M Training Centre, Gopa, P O -

Keshpura, Near T V Centre Kendrapara,Orissa

40

53 Vivekananda Institute Of Social Work &Social

Science ( V I S W A S S ) School OfNursing, P

No. 474, Pitapalli Square N H-5,P O

KumarbastKhurda 752055 ,Orissa

60

24

Annexure –II

SBI CHALLAN

BANK’S SLIP STATE BANK OF INDIA

(POWER JYOTI ACCOUNT)

CANDIDATE’S SLIP

STATE BANK OF INDIA

(POWER JYOTIACCOUNT)

DEPARTMENT’S SLIP

STATE BANK OF INDIA

(POWER JYOTIACCOUNT)

GNM SELECTION

COMMITTEE-CUM-

DIR,NURSING,ODISHA

ACCOUNT No.30760830432

Name of candidate

Branch Name

Branch Code

Amount. Rs.500/-

In words (Rupees Five

Hundred) only

Journal No. …………………..

(To be filled by Bank)

Signature of

Candidate :

Signature of

Bank Officer :

GNM SELECTION

COMMITTEE-CUM-

DIR,NURSING,ODISHA

ACCOUNT No.30760830432

Name of candidate-:

Branch Name

Branch Code

Amount. Rs.500/-

In words (Rupees Five

Hundred) only

Journal No. …………………..

(To be filled by Bank)

Signature of

Candidate :

Signature of

Bank Officer :

GNM SELECTION

COMMITTEE-CUM-

DIR,NURSING,ODISHA

ACCOUNT NO-30760830432

Name of candidate-:

Branch Name

Branch Code

Amount. Rs.500/-

In words (Rupees Five

Hundred) only

Journal No. …………………..

(To be filled by Bank)

Signature of

Candidate :

Signature of

Bank Officer :

Fees remitting Branch may collect Rs.50/- (Rupees Fifty) only towards non-home charges from the remitter SEPARATELY.

25

List of Nodal Center

Annexure – III

Sl.

No. Nodal Centre Tagging District

1 ANM TC, Balasore Balasore, Bhadrak

2 ANM TC, Bolangir Bolangir

3 ANM TC, Baripada Baripada, Mayurbhanj

4 ANM TC, Bhawanipatna Kalahandi, Nuapada

5 ANM TC, Berhampur Gajapati

6 GNM TC, Berhampur Ganjam

7 ANM TC, Daspalla Nayagarh

8 ANM TC, Deogarh Deogarh

9 ANM TC, Dhenkanal Dhenkanal, Angul

10 ANM TC, Jaypore Koraput, Malkangiri,

Nabarangapur, Rayagada

11 ANM TC, Kendrapara Kendrapara, Jajpur

12 GNM TC, Cuttack Cuttack, Jagatsinghpur

13 ANM TC, Keonjhar Keonjhar

14 ANM TC, Phulbani Kandhamal

15 ANM TC, Puri Puri

16 ANM TC, Sambalpur Baragarh

17 GNM TC, Sambalpur Sambalpur

18 ANM TC, Sundergarh Sundergarh, Jharsuguda

19 ANM TC, Boudh Boudh

20 ANM TC, Sonpur Subarnapur

21 ANM TC, Bhubaneswar Khurda

22 ANM TC, Bhubaneswar Khurda

26

Annexure – IV

CASTE CERTIFICATE

Miscellaneous Certificate No. ……………………………………..

This is to certify that Sri / Smt. / Miss

…………………………………………………………

Son / Daughter / Wife of Sri

……………………………………………………………………

of Village / Town

…………………………………………………..……………………………

P.S. ………………………………………………. Tahasil

………………………………………

in the District of ………………………………………………….……… in the

State of Odisha

belongs to the ……………………………………. Caste / Tribe which is

recognised as Scheduled Caste / Tribe under Constitution (Scheduled Caste /

Tribe) order 1950 as amended by the Scheduled Castes and Scheduled Tribes

(Amendment) orders Act 1976.

Sri / Smt. / Miss …………………………………………………………. and

………………..

……………………………………….. family are ordinarily reside in Village /

Town ……………………………………………………………… P.S.

……………………………… Tahasil …………………………… in the District of

………………..…………………… of the State of Odisha

Full Signature of the applicant

Round seal of Office

Signature of the competent

authority

Date –

Designation (with seal of

officer)

27

Annexure –V

FORM No. III

Office of the ………………………………………………………………….. Date

……………..

Miscellaneous Certificate Case No. …………………………………...

RESIDENT / NATIVITY CERTIFICATE

This is to certify that Sri / Smt. / Miss

………………………………………………………

Son / Daughter / Wife of Sri

…………………………………………………………………

is a native of the district of

………………………………………………………………….

in the State of Orissa and he / she belongs to P.S. ……………………………………... Tahasil

………………………….... in the District of………………………………..……. since

…………………………. years

The certificate is being granted only for the purpose of G.N.M. Training Course 2015- 16 Odisha

Full Signature of the applicant

Round seal of the Office

Signature of the competent

authority

Date –

Designation (with seal of officer)

28

Annexure - VI

GOVERNMENT OF ODISHAOFFICE OF THE ORISSA SAINIK BOARD,

BONAFIDE CERTIFICATE

1. Certificate that No.

Rank Name

Vill P.O

P.S

Dist. (Odisha) is a bonafide Serviceman/

Ex-serviceman of the Indian Army/Air force/Navy/CRPF/BSF.(In case

of widow: (Name) Smt.

date of death of husband ,

Cause of death: Battle Casualty killed in action/death on duty attributable to Military

Service/death after discharge from Armed Forces*). He/ She been issued with Ex-

serviceman/ Identify Card bearing Machine No._ .

2. Shri/Kumari is the

dependent son/daughter of the above named Ex-serviceman/widew of serviceman/

Ex-serviceman. His/Her date of birth is

as per his/her Birth Certificate/ SLC/Mark- sheet/

Exam. Admit Card/ Board Certificate/ Military Discharge Book/issued by

the

bearing Srl.

No. He/She is eligible for admission in Education/

Technical Institutions in seats reserved for the children of Defence Serviceman/ Ex-

serviceman personnel/ Defence personnel killed in action.

(*Strike out those are not applicable)

Place:

Date:

Secretary Odisha Sainik Board/

Razya Sainik/ Zilla Sainik Board

(Office Seal)

29

Annexure-VII

U N D E R T A K I N G

(To be submitted by the selected candidates after admission in the respective Training

Centre)

I Sri / Smt. (Name of the Local Guardian)

…………………………………………………….

Address

………………………………………………………………………………………

……………………………………………………………………………………...

Under take to act as the Local Guardian of Miss / Smt.

………………………………………. Daughter / Wife of Sri

…………………………………………………………………………..during her

period of study in the H.W.(F) Training Centre,

…………………………………….........

I also undertake to act on behalf of the parents / husband of the said

student during the period of study in the G.N.M. Training Centre,

……………………………………......... for which I have been empowered by the

parent / guardian / husband of the said student.

I further undertake to take custody of the above student as and when required by

the school authorities and to ensure that she maintains the academic discipline and

good conduct during the period of study in the aforesaid institution.

Place -

……………………………..

Date -

………………………………

Signature in full of the Local

Guardian

ATTESTATION BY PARENT / HUSBAND / GUARDIAN

The above undertaking has been signed in my presence, I empower Sri /Smt.

…….………………………………………………………………………..to act as

Local Guardian of my daughter / wife Miss / Smt.

………………………………………………… during the period of her

studentship in the G.N.M .Training Centre,

…………………………………….........

Place:

Date :

Signature in full of the

Parent/Guardian/Husband

Signature in full of the Student

30

Annexure-VIII

CERTIFICATE OF PHYSICAL FITNESS IN RESPECT OF SELECTED CANDIDATES

FOR ADMISSION INTO THE GENERAL NURSING & MIDWIFERY TRAINING

COURSE-2015.

Name of the Candidate in full

Age Sex Height Weight

Heart Eye Teeth Liver

Lungs Spleen Blood Pressure Blood

Group

Please indicate if Pregnant (In case of female candidate) Date

of L.M.P. (In case of female candidate)

Previous Medical History, if any Personal

Remarks of Identification

1.

2.

I certify that I have examined the above named candidate and cannot discover that she /he has any

diseases, constitutional weakness or bodily infirmity and I consider that the candidate is physically and

mentally fit to undergo General Nursing and Midwifery Training Course under Health & F.W. Department.

SIGNATURE OF THE CANDIDATE

Signature & Seal of authorized Medical Officer

(Govt. of Odisha)

Designation –

Date -

31

24