t bhopal memorial hospital & research … of post basic b.sc final-23...prospectus academic year...

BHOPAL NURSING COLLEGE. BMHRC, BHOPAL

T

BHOPAL MEMORIAL HOSPITAL & RESEARCH CENTRE

Indian Council of Medical Research, Department of HealthResearch, Ministry of Health & Family Welfare, Govt. of India

Raisen Bypass Road, Karond, Bhopal – 462038

Phone No.: 0755-2742279, 0755-2742212-16 Extn. 8821, 8803, 8805, 8831

Fax: 0755-2748309

Email: [email protected] Website: www.bmhrc.org

BHOPAL NURSING COLLEGEPROSPECTUS

ACADEMIC YEAR 2015-16

POST BASIC B.Sc. NURSING

Recognized by Indian Nursing Council, New Delhi

Approved by MP Nurses Registration Council, MP

Affiliated to Barkatullah University, Bhopal

Cost of prospectus with application

Free of cost for SC/ST/PH: only Rs. 50/- if, by post

OBC category: Rs. 300/- by hand & Rs. 350/- by post

UR category: Rs 500/- by hand & Rs. 550/- by Post

BHOPAL NURSING COLLEGE. BMHRC, BHOPAL

Index

Sl.No.

Title Page No

1. MESSAGE FROM THE DIRECTOR 12. MESSAGE FROM THE PRINCIPAL 23. Introduction

Mission Vision Philosophy

3-5

4. Objectives of the course P.B.B.Sc. Nursing

5

5. Facilities available Curricular zone Clinical zone Community zone Co-curricular zone

5-7

6. Courses offered Name of the Courses Seats Available Reservation of seats for each category

7-9

7. Eligibility criteria for each course 98. Procedure to apply 109. Selection Process

Entrance test/counseling Syllabus

10-12

10. Fee structure 1311. Hostel Accommodation 13-1412. Code of Conduct 14-1613. Calendar Note 1714. Common Instruction 1715. Annexure

Application form - IAdmit Card - IIFormat for OBC certificate - IIIDeclaration by OBC candidate - IVFormat For SC/ST Certificate - VEndorsement by the employer, if the applicant is in service - VI

Medical examination form - VIIAffidavit by the student (Anti-Ragging) - VIIIAffidavit by the Parent/Guardian (Anti- Ragging) - IXHostel admission form - X

18-2122232425-262728-29303132

BHOPAL NURSING COLLEGE, BMHRC, BHOPAL

(1)

Message from the Director

Dear Candidates,

Welcome to Bhopal Nursing College, BMHRC, Bhopal.

I have great pleasure in presenting to you the prospectus for Post Basic B.Sc. Nursing

course for the year 2015-2016.

BMHRC is a Hospital cum, research cum Super-speciality teaching Institute, under Indian

Council of Medical Research, Department of Health Research, Ministry of Health and

Family Welfare, Govt. of India. Bhopal Nursing College is one of the finest nursing

institutes in the state of Madhya Pradesh attracting students from all over India. BMHRC

has excellent infrastructure facilities like 357 – bedded - Super Specialty Hospital, state of

art class rooms, clinical laboratories, library, multipurpose hall cum auditorium, play

grounds & girls hostel for adequate students. The aim is not only to teach Nursing but an

overall personality development of students.

I wish you all a bright career in the field of Nursing. In the coming years, BMHRC will

emphasize towards strengthening of Nursing courses, PhD Programme & Post Graduation

courses will be introduced in the field of Nursing. The aim is not to just create Nurses but

build a future.

Prof. Manoj Pandey

Director

BMHRC, Bhopal


(2)

Message from the Principal

Dear candidates,

We welcome you to Bhopal Nursing College, BMHRC, Bhopal.

If you wish to grow a garden, you need a lot of water in the form of perspiration. Bhopal

Nursing College is under the supervision of BMHRC, a Super-speciality Health Care Hospital,

which was set up to provide health care to the victims of 1984 gas tragedy in Bhopal.

Bhopal Nursing College, BMHRC is completing 11 years of imparting health education and

preparing health workers under the able guidance of expert faculty. It already has GNM and

post-basic degree courses. It has produced very sparkling results and its students have

qualified for some good placements in the country and abroad.

Under the able guidance of BMHRC management the college is evolving into a strong and

productive unit providing health care systems and also providing the best health workers to

the country.

I am hopeful that this institution will grow to promote and propagate health care systems

and ideologies of Florence Nightingale, so that humanity may not suffer from the reverses of

health, and world citizens may live a healthy and happy life.

Ms. Anita Nand

Principal


(3)

INTRODUCTION

Bhopal Memorial Hospital & Research Centre

“Caring is a way of life”. This is the motto at Bhopal Memorial Hospital and Research

Centre (BMHRC), a 357-bedded multi-specialty tertiary care centre situated at Bhopal,

Madhya Pradesh. Bhopal Nursing College (BNC), the institute which started in 2003, is an

integral part of this Hospital.

The hospital is a referral and tertiary care centre for lakhs of post Bhopal gas disaster

patients and their first degree relatives who are first assessed at the primary care level in the

eight health centres (satellite health centers) spread around the city of Bhopal, and then referred

to the advanced and specialized tertiary departments at the hospital which include the

following

Anesthesia Cardiology Cardio-thoracic and Vascular surgery

Medical Gastroenterology Microbiology Nephrology

Neurosurgery Ophthalmology Pulmonary Medicine

Neurology Pathology Psychiatry

Radiology Research Surgical Gastroenterology

Surgical Oncology Transfusion Medicine Urology

The state-of-the-art infrastructure of the hospital with strategically designed health care

facilities provide the highest quality of professional care. A team of diligent, dedicated and

highly qualified health professionals, including specialists and super specialists, nursing and

paramedical staff are providing round-the-clock services to the patients.


(4)

Bhopal Nursing College

Bhopal Nursing College provides quality training for Post Basic B.Sc. Nursing and GNM. It is

recognized by Indian Nursing Council, MP State Nursing Council, and affiliated to Barkatullah

University, Bhopal

MISSION

Caring, Compassion, and Commitment to excel in the field of health care is the mission

at Bhopal Nursing College. Academic excellence is evident in the involvement of faculty and

students in research.

VISION

Bhopal Nursing College provides quality nursing education to make itself a centre of

excellence and to be recognized as a leader in nursing education. We make a difference in the

lives of our students by way of the practice of our profession, and caring the health of the

people we serve.

PHILOSOPHY

Bhopal Nursing College believes that-

Health is a state of well-being that enables a person to lead a physically, psychologically,socially, and economically productive life. Health is a right of all people.

Nursing is a dynamic, therapeutic and educative process in meeting the health needs ofsociety and assists the individual & family to achieve their potential for self direction.

Nursing is a profession, which is influenced by advances in science and technology,encouraging innovations in nursing and applying evidence based practices.


(5)

Nursing is based on values of caring and aims to help individuals to attain independence inself-care.

All-round development of the students is important to make them an individual, a citizen aswell as professional nurse.

The teacher has the responsibility to be a role model and to create learning environment thatenables students to acquire inquiry- driven, self- directed learning and to foster an attitudeof life- long learning.

OBJECTIVES

Post Basic B.Sc. Nursing

The objectives of Post Basic B.Sc (Nursing) programme is to upgrade the Diploma (GNM)

nurses to

enable nurses with a sound knowledge of nursing to function as an efficient member of the

health team, with the competence in all level of health care settings.

help nurses to develop an ability to co-operate and co-ordinate with members of the health

team.

provide personal and professional development to contribute at its maximum to the society.

serve as a base for further professional education and specialization in nursing.

prepare nurses to keep pace with advanced professional and technological developments

and use the same for providing nursing care services.

emphasize the importance of continuing learning for their personal and professional

development.

enable professional nurses to participate in research activities and utilize research findings

in improving nursing practice.

demonstrate leadership qualities and managerial skills in different health settings.

FACILITIES AVAILABLE

A. CURRICULAR ZONE

Lecture Halls


(6)

Bhopal Nursing College has spacious lecture halls with comfortable seating arrangements and

equipped with advanced teaching aids.

Institute Library

The library of the BMHRC institute is stocked and equipped with more than 3,000 importantmedical & nursing books, Indian and International e-journals, newspapers, periodicals andmagazines. E-journals can be accessed through internet using software Proquest and J-Gate +

Information Technology Centre/Computer LabThe college has well established computer lab with internet facility which is accessible to alllearners so as to keep themselves updated with the current trends and technologies in nursing.

Maternal and Child Health (MCH) LabMaternal and child health is given prime attention in our country. The MCH lab is equippedwith maternity examination model, Gynecological examination model, delivery model, chartsand other equipments.

Nursing Foundation LabNursing is a skill based profession. Nursing Foundation Lab is equipped with all advancedequipments, articles, models, charts, and mannequins to enhance the nursing skills of thelearners.

Community Health Nursing LabCommunity lab is well equipped to develop skills for rendering service in rural and urbancommunity.

Nutrition LabNutrition lab is equipped and well furnished with utensils, nutritional charts, models. It is wellventilated, lighting, and adequate water facilities.

Pre-clinical Science LabThe lab is equipped with models, charts, specimens, microscopes and slides to provide betterunderstanding of Human Anatomy, Physiology and Microbiology.


(7)

Audio-visual LabThe audiovisual lab consist of OHP, LCD, TV, Posters, Flannel board, Model and otherteaching learning materials for effective teaching learning process.

Multipurpose Hall (Auditorium)The institute has an advanced auditorium with centralized air conditioning, adequate seatingfacility, modern light system and digital sound facility. Individual mike control facility is alsoavailable on chairs.

B. CLINICAL ZONEParent Hospital

Bhopal Memorial Hospital & Research Centre is the parent Hospital of Bhopal NursingCollege. It is 357 bedded Super Specialty Hospital with advanced diagnostic laboratory.

Affiliated HospitalBhopal Nursing College is affiliated with 320 bedded Government Jai Prakash Hospital,Bhopal for Maternity and Pediatrics training.

C. COMMUNITY ZONEStudents of Bhopal Nursing College are regularly utilizing the rural and urban community areacovered by Community Health Centre, Gandhi Nagar, Bhopal.Activities of the nursing students includes early identification of health problems by regularhome visits, participation in National Health Programmes like Pulse-Polio ImmunizationProgramme, Measles Immunization Awareness Programme, Community NutritionDevelopment Programme, Reproductive and Child Health Services and School Health Servicesetc.

D. CO-CURRICULAR ZONERecreational ActivitiesFacilities of in-door games like chess, badminton, and carom, and out-door games like volleyball, handball, tennis, cricket, hockey and football are available for the nursing students. Onehour of outdoor activity per day is promoted for better physical health of the students.

Cultural ActivitiesCultural programmes are organized on various occasions. The students are encouraged toparticipate in dance, skits, mime shows, tableaux etc to help promote inherent talent of thenursing students.

COURSES OFFERED

S.No Courses Duration Seats availableTotal UR OBC SC ST PH Government

Sponsored candidate1. P.B.B.Sc. Nursing 2 years 50 25 13 08 04 02* 5 seats

*3% reservation will be given as per INC guidelines.


(8)

Note:

P.B.B.Sc. Nursing

Five seats in Post Basic B.Sc. Nursing course will be considered for Sponsored candidates who

are in the employment of Hospitals/Institutions under Central/State Govt. or Schools of

Nursing under Central/State Govt. and whose names are sponsored by their employer. The

original application of the sponsored candidate must be forwarded by the employer. Weightage

of 05 marks in the entrance test will be given to the sponsored candidate. The sponsored

candidate if selected should submit a relieving letter confirming sponsorship at the time of the

admission. In case of non- availability of eligible sponsored candidates, the vacant seats will be

open to other candidates. The candidate must produce the sponsorship letter along with the

filled application. Sponsored candidate receiving 5 marks, if selected should submit a relieving

letter confirming sponsorship at the time of admission.

Reservation of seats as per Govt. of India

Other Backward Class (OBC) : 27%

Scheduled Caste (SC) : 15%

Scheduled Tribe (ST) : 7.5%

Physically Handicapped : 3%

If requisite number of suitable candidates is not available to fill up the seats reserved for

the Scheduled Castes, the same will be filled by candidates belonging to the

Scheduled Tribes and vice-versa. In case suitable candidates are not available from the

two reserved categories, the vacant seats will be filled up by the candidates from the

OBC category.

In case suitable candidates are also not available in the OBC category, the same will be

filled up by the candidates from the unreserved category. Issue date of caste certificate

of OBC category should not be older more than one year from the date of application.

In respect of candidates belonging to SC and ST category a self-attested copy of

community certificate should be produced. For candidates belonging to OBC non-

creamy layer certificate along with application should be attached from any of the

following authorities (District Magistrate/Additional District Magistrate/Collector/

Deputy Commissioner/Additional Deputy Commissioner/Deputy Collector/1st class

Stipendiary Magistrate/City Magistrate/Sub divisional Magistrate/Taluk Magistrate/

Executive Magistrate/Extra Assistant Commissioner/Chief Presidency Magistrate/

Additional Chief Presidency Magistrate/Revenue officer not below the rank of Tehsildar

and Sub-Divisional officer of the area, where the candidate and/or his/her family

normally resides) and the original certificate should be produced at the time of

counseling/personal interview.


(9)

If the candidate Fails to produce Non-Creamy layer certificate (NCLC) and community

certificate he/she will be considered as unreserved category

The Non-Creamy layer certificate, not older than one year, should be produced from

competent authority.

Physically Handicapped

There is provision of 3% disability reservation as per Government of India and Indian

Nursing Council, to be considered with a locomotor disability to the tune of 40% to 50%

of the lower extremity. Other eligibility criteria with regard to age and qualification will

be the same as prescribed for each nursing programme. Candidates applying for

disability quota may enclose a disability certificate from disability board.

ELIGIBILITY CRITERIA (as per Indian Nursing Council, New Delhi)


Male and female candidates are eligible to apply for the course.

The candidates should have passed the Higher Secondary or Senior Secondary or

Intermediate or 10+2 or an equivalent examination recognized by the university for this

purpose. Those who have done 10+1 in or before 1986, will be eligible for admission.

The candidates should have passed and obtained a certificate in General Nursing and

Midwifery and registered as Registered Nurse /Registered Midwife with the State Nurses

Registration Council.

A male nurse, trained before the implementation of the new integrated course besides

being registered as a nurse with State Nurses Registration Council, shall produce

evidence of training approved by Indian Nursing Council for a similar duration in lieu of

midwifery in any one of the following areas

O.T. TechniquesOphthalmic NursingLeprosy NursingTB NursingPsychiatric NursingNeurological and Neuro-Surgical NursingCommunity Health NursingCancer NursingOrthopedic Nursing

Candidates shall be medically fit.

Students shall be admitted once in a year in the month of July.


(10)

Procedure to Apply

A candidate seeking admission to Post Basic B.Sc. Nursing course shall submit duly

filled application form attached with prospectus. For unreserved candidates it can be

obtained from the office of the Academic Cell, BMHRC on payment of Rs. 500/-

through Demand Draft of any commercial bank drawn in favour of Director, Bhopal

Memorial Hospital & Research Centre, payable at Bhopal. For candidates of the

OBC category the cost of the application form with prospectus will be Rs 300/- and

demand draft should be prepared as above. For SC/ST and physically handicapped

candidates the form may be obtained free of cost.

Prospectus can also be obtained through Post by sending a Demand Draft of Rs 550/-for unreserved category and Rs 350/- for OBC category, in favour of Director BhopalMemorial Hospital & Research Centre, payable at Bhopal. For SC/ST andphysically handicapped there is no application fee however, Rs. 50/- is required if formis requested by post.

Last date of receiving DD for sending Application form with prospectus by post is13.07.2015 up to 5:00 pm.

Last date for receiving filled application is 20.07.2015 up to 5:00 pm for Post BasicB.Sc. Nursing programme. No application form will be received after the closing date.

The Academic Cell does not take any responsibility for Postal Delay/Losses. Fees once paid will not be refunded in under any circumstances. Self attested copies of the certificates along with filled application form should be

submitted to The Academic Cell, BMHRC, Bhopal.

Postal AddressAcademic Cell, Bhopal Memorial Hospital & Research Centre, Raisen By-pass Road, Karond,Bhopal (MP) 462038.

Selection Process

Phase I: Entrance Test

The scheme of Entrance Examination is as followsObjective type (MCQs) paper of two hours duration and from six subjects as follows:

S. No. Subjects Marks1. Fundamentals of Nursing, Medical Surgical Nursing

including Professional Trends in Nursing.25

2. Anatomy, Physiology and Pharmacology 153. Obstetrics Nursing and Midwifery 15

4. Pediatric Nursing 15

5. Community Health Nursing 15

6. Psychiatric Nursing 15Total 100


(11)

Common instructions for entrance exam for Post Basic B.Sc. Nursing course

Duration : 2 Hours

Marks : 100

Time : 11:00 am to 01:00pm

Venue : Bhopal Nursing College, BMHRC, Bhopal

Date : 26.07.2015 (Sunday)

Entrance Examination will be conducted in English language only.

Each correct response will get a score of one mark (1).

More than one response will get a score of zero (0).

No credit will be given for the question not answered.

Based on the result of the Entrance Examination, separate merit lists will be prepared for the

Unreserved, OBC, Scheduled Caste, Scheduled Tribe and physically handicapped categories.

Result of successful candidates in entrance exam will be displayed on college notice boardas well as BMHRC website (www.bmhrc.org).

Individual correspondence/telephonic information in this regard will not be entertained.

Admit cards for appearing in entrance exam will be issued to eligible candidates. If the

candidate does not receive admit card by 24.07.2015 , he/she may contact Academic cell,

BMHRC personally on or before 25.07.2015, No candidate will be allowed to appear in

exam without Admit card.

Admit card will be sent by registered post; however institution will not be responsible for

postal delay/loss.

Phase II: Personal interview/ Counseling

In Personal interview/counseling, document verification and allotment of seats will beCarried out.

If a candidate found to have furnished any false Information /documents Testimonials, the

admission of the candidate shall be cancelled at any stage of her/his admission without any

further notice and legal action as deemed necessary will be taken.

Note:

Allocation of admission will be on merit basis. For each category number of candidates

called for counseling will be based on availability of seats.


(12)

The following documents to be produced by the selected candidates along with original at

the time of admission

S.No.

Documents UR OBC SC ST PH Remark

1. 10th pass Mark sheet

2. (10+2) pass Mark sheet

3. GNM 1st, 2nd, 3rd &Internship pass Mark sheet

4. GNM Diploma

5. State Nursing CouncilRegistration – RN & RM

6. Transfercertificate/Migrationcertificate

For candidatesother than M.P.

7. Caste Certificate

8. Income Certificate

9. Non creamy layercertificate

10. Domicile Certificate

11. Affidavit in case ofchange of Name

12. Recent Passport size photo– Colored (10)

13. Recent Stamp size photo –Colored (4)

14. Parents and Guardian’s

photograph

15. Disability Certificate from

disability Board

Original certificates will be retained in the office of the Principal, and the same will bereturned at the time of completion of course.


(13)

Fee Structure for Post Basic B.Sc. Nursing Programme

S.

No.List of Items

Post Basic B.Sc. 1st yearIn Rupees (Per annum)

Post Basic B.Sc. 2nd yearIn Rupees (Per annum)

1. Registration fees 5 --

2. University Development Fee (one time) 600 600

3. Tuition fee 250 250

4. Identity card (one time) 50 --

5. Library & Breakage 250 250

6. Health Fee 100 100

7. Games Fee 1000 1000

8. Student Welfare Fund 20 20

9.Enrolment fee for MP Domiciles 155 --

Others 320 --

10. Annual Exam fee (Theory) 2795 2795

11. Annual Exam fee (Practical) 200 200

12. Hostel fee 1200 1200

13. Security Money (refundable) 5000 --

14. Transcription Fee (Optional) -- 2000

15. Water and Electricity Fee 2000 2000

16. Laboratory Fee 120 120

17. Computer Lab Fee 200 200

These fee/charges are subject to change if required.

Note

All University/Nursing Council fees/dues will be charged as per University/Council norms andsubject to change.

No fee shall be refunded once paid. Security money will be refunded after the completion of course. The entire fees should be paid at the time of admission. Clinical fee, Transportation fee, Graduation & Annual Day fee will be as per the decision of

management. Mess charges are Rs. 1500/- per month .These are payable directly to the service provider by the

students. Student Nursing Association (SNA) subscription of Rs. 1500/- per year, if students opt for SNA

membership.

Hostel Accommodation

For female candidates admitted to Post Basic B.Sc. Nursing programme can reside inthe hostel.

Hostel is not available for male students. Allotment of rooms in the hostel shall be made by a Committee chaired by the Deputy

Director Engineering Services, BMHRC, Bhopal and is subject to the availability.


(14)

Students shall have to abide by the rules and regulations of the Hostel, failing which theirallotment shall be cancelled without any further notice.

Cooking is not permitted in rooms and one cannot carry mess food from the mess toroom.

Clothes are only to be washed in bathrooms.

Visitors are allowed only in visitors’ room with permission of the hostel warden.

Code of Conduct for Students in College

1. All powers relating to discipline and disciplinary action are vested with the Director,BMHRC.

2. The Director BMHRC may delegate some power as he deems fit to the Principal, BhopalNursing College on his behalf.

3. Without prejudice to the generality of power to enforce discipline under the rules, thefollowing shall amount to act of gross indiscipline:

Physical assault or threat to use physical force against any member of the teaching ornon- teaching staff of any department/ centre or any other person within the premises/campus.

Violation of the status dignity and honor of students belonging to the Scheduled Caste,Scheduled Tribes and Other Backward Castes.

Carrying of any weapon to threaten. Any attempt at bribing or corruption in any manner. Destruction of institutional property in any manner. Creating ill-will of intolerance on religious or communal grounds. Causing disruption of the functioning of the institute in any manner. Students admitted to the Institute shall have to follow rules and regulations given time

to time. Students will have to attend classes (80%) and practical hours (100%) regularly as per

the INC, State Nursing Council & University norms. Student who absentehimself/herself from classes continuously for more than 15 days without permissionfrom Principal shall be termed as absent without reason and liable to be terminated fromthe course.

In case of illness, permission shall have to be obtained from the Principal/ ClassCoordinator to remain absent from College.

Students shall wear the prescribed uniform while on clinical duty and during allacademic activities.

When a student is found guilty of breach of discipline / misconduct within or outsidethe premises of the Institute, the Principal/ Director may act according to the nature andgravity of the offence, any of the following action may be taken

SuspensionExpulsion/ Rustication from the Institute/CourseDisqualification from Institutional/ University Examination

Mobile phones are strictly prohibited in or outside the college campus. Ragging is strictly prohibited in or outside the college campus.


(15)

Code of Conduct for Students In Hostel

1. All rules and regulations of the hostel are to be obeyed strictly by the students.2. Each student is responsible for the care of hostel property such as room

furniture etc provided for their use.3. If any student is found to be involved in immoral activities, unruly and

undisciplined conduct she will be punished by the Committee chaired by thePrincipal, Bhopal Nursing College, Bhopal (MP) under intimation to theDirector BMHRC, Bhopal(MP).

4. Students are advised to keep their valuable things or cash under lock, in case ofmissing anything, hostel in-charge or college authority will not be responsible.

5. The college authorities reserve the right to check the hostel periodically withoutprior notice.

6. Visitors will not be entertained inside the hostel room; all visitors are allowed invisiting room only.

7. Permission to leave station will be granted by the Principal on receipt of awritten request from the students and same has to be submitted to hostelwarden.

Anti-ragging

Provisions of UGC Regulation 2009 on curbing the menace of ragging in higher

educational institution, in view of the direction of the Hon’ble Supreme Court of India

will be followed strictly.

Ragging in any form is strictly prohibited, within or outside the premises of the

College/ Institution.

Any act of misconduct or malpractice by which dominant power or status of senior

students is brought to bear on students freshly enrolled or students who are in any way

considered junior or inferior by other students and includes individual or collective acts

or practices which.

Involve physical assault or threat or use of physical force.

Violate the status, dignity and honor of female students.

Violate the status, dignity and honor of students belonging to the Scheduled Caste and

Scheduled Tribes. Expose students to ridicule on contempt and affect their self-esteem. Entail verbal abuse and aggression, indecent gestures and obscene behavior. The Principal/Director/Anti Ragging Committee shall take immediate action on any

information of the occurrence of ragging.

Measures are taken by the institution to prevent Ragging

Written notice expressing that ragging is totally prohibited in institution. Those who are found guilty of ragging/ abetting ragging, actively or passively or being

part of a conspiracy to promote ragging are liable to be punished in accordance withthese regulation as well as under the provisions of any penal law for the time being inforce.

An Anti-Ragging Committee has been constituted by the Institute.


(16)

The applicant should prepare and submit the following at the time of admission1. Affidavit by the student (Annexure-VIII)2. Affidavit by the parent/ guardian (Annexure-IX)

The content of Annexure VIII and Annexure IX should be typed/printed on a stamp paper ofRs 10 each, which should be submitted at the time of admission.

BMHRC, Anti Ragging Committee

S. No Name Post Mobile No. E-mail Id

1Dr. Anurag Yadav,Professor, Dept. of Anesthesia

Chairperson 7869389106 [email protected]

2 Dr. Surbhi Sahay, Associate ProfessorDept. of Anesthesia

Member 9669097432 [email protected]

3Dr. Rupesh Ranjan,Clinical Neuro- PsychologistDept of psychiatry


4 Mr. Baiju S, Tutor, Bhopal Nursing College Member 9179408127 [email protected]

5 Mrs. Prabha Agnibhoj, LecturerBhopal Nursing College


6 Mrs. Ritu N Sonber, TutorBhopal Nursing College


7 Mr. Prahlad Singh Vishwakarma,Coordinator (I/C) Paramedical institute


8 Mr. Nitin Bhatia, Sr.Manager (Operations) Member 9826198990 [email protected]

9 Dr. Hanni Vashudev Gulwani,Asst Professor Dept.of Pathology


Mr. Anupam Pathak, Barkatullah University 9425377696 [email protected]

Anti Ragging Toll Free Number

1800-180-5522

E-mail Id: [email protected]

It is to be noted that making a false complaint is punishable under CRPC 182 and 211.

Placement

In order to further extend support services to the students who are pursuing various nursingcourses at BMHRC, a “Campus Placement Cell” to facilitates the process of prospectivesuitable employment opportunities that are commensurate with the personal profile of thestudents.

Prohibition of and Punishment for Sexual Harassment

In compliance with the guidelines of the Supreme Court, Bhopal Nursing College has adopteda policy that aims to prevent / prohibit / punish Sexual Harassment of a female at BhopalNursing College and BMHRC premises. Incidents of Sexual Harassment may be reported tothe Director, BMHRC.


(17)

Calendar Note

Programme Post Basic B.Sc. Nursing

Last date for sendingprospectus by mail

13.07.15

Last date to receive filledapplication form

20.07.2015 up to 05:00 pm

Date for Entrance Test 26.07.2015 Sunday 11:00 am to 1:00 pmWebsite www.bmhrc.orgDemand Draft SC/ST/PH OBC UR

Free of Cost Rs.50/- only if requiredto be sent by post

Rs. 300/- by hand,Rs.350 by post

Rs.500 by hand,Rs.550 by post

Demand Draft in favour of Director, Bhopal Memorial Hospital & Research Centre,payable at Bhopal.

Postal Address Academic Cell, Bhopal Memorial Hospital & ResearchCentre, Raisen Bypass Road, Karond, Bhopal (MP) Pin

462038.Admit Card if not received by 24.07.15 can be obtained from Academic Cell by 25.7.15

upto 5:00pm

Common Instructions

1. One recent clear passport size colored photograph with light background is required tobe pasted on the application from at the space provided. Polaroid photographs are notacceptable.

2. Photographs MUST be taken on or after 31st

May, 2015 and should show date thephotograph was taken in lower one-fourth of Photograph.

Important:1. The name and date on the photographs must be clear and legible.2. One should not wear cap or sun glasses etc when photographed. Spectacles are allowed.3. Photograph should be pasted (NOT stapled) on application form.4. The photograph on the application form/admit card/attendance sheet should be

unattested.5. Application not complying with these instructions or with unclear photograph will be

rejected.6. Keep a few identical photographs for use at the time of entrance examination/admission.


(18)

Application form No: Annexure - I

APPLICATION FORM

BHOPAL NURSING COLLEGEBHOPAL MEMORIAL HOSPITAL & RESEARCH CENTRE

(INDIAN COUNCIL OF MEDICAL RESEARCH, DEPARTMENT OF HEALTH RESEARCH

MINISTRY OF HEALTH & FAMILY WELFARE, GOVT OF INDIA)

RAISEN BYPASS ROAD, KAROND, BHOPAL – 462 038

Tel. No. 0755-2742279, 0755 – 2742212-16, Extn. 8803, 8821

(Recognized by: Indian Nursing Council & MP State Nursing Council & Affiliated to Barkatullah

University, Bhopal (M.P.).

Application for admission to Post-Basic B.Sc. Nursing

For Sponsored candidates: Through proper channel by Employer.

*Demand Draft No

Fee deposited Rs

Bank Name/Address

Bank Code

*For SC/ST/Physically challenged, No fee is required to be paid.

Note:a) Application form to be filled by candidate in block letters & in her/his own handwriting.b) All statements made in this form must be supported with attested copies of certificates.

1. Course applied for(please tick which is applicable)


2. Candidate’s Name in full (In English-Capitals).

vkosnd dk fgUnh es uke3. Father’s/Husband’s Name4. Mother’s Name5. Date of Birth (date/month/year, 00/00/0000)6. Age in years7. Marital Status (whether married/unmarried / widowed/ divorced

8. Category under which applying i.e. Unreserved / OBC/SC/ST/Physically disabled

9. Nationality10. Religion11. State to which belongs12. Address for correspondence / Local Guardian

Phone number with STD code Mobile number, Email id

13. Permanent Address Phone number with STD codeMobile number, Email id

Affix photographas per instructionsin the prospectus(with name &

date)


(19)

14. Academic Qualifications

Name ofExamination

Board/University Year ofPassing

TotalMarks

Marksobtained

Division/Class

% ofmarks

Number ofattempts

Distinctions /Awards if any

10th

10+2

15. Professional Qualifications : (applicable to Post-Basic B.Sc. (N)

Name ofthecourse

Institution/College/ School

Council/University/ Board

Year ofPassing

TotalMarks

MarksObtained

% No. ofattempt

RegistrationNo. RN/RM

Distinctions/ Awards ifany

GNM

16. Detail of Experience

Designation Institute/Hospital

Period / Date Total Experience

From To Years Months Days

*Those presently in service must apply through their employers or enclose an NOC from theiremployers.

19. Whether deputation or study leave: __________________________________or extraordinary leave or private candidate

“RAGGING IS TOTALLY BANNED AT BMHRC”

17. Whether presently in service or not*

18. Name & Address of present employer (ifin service) with Phone No/E-mail id


(20)

20. Check List: One set of below mentioned documents with self-attested to be submitted along

with filled application form

S. No DOCUMENTS YES NO

1. 10th pass Mark sheet

2. 10+2 pass Mark sheet

3. Mark SheetGNM 1st, 2nd, 3rd Year & Internship

4. Diploma/ Degree certificateGNM

5. State Nursing Council RegistrationR.N & R.M

6. Transfer certificate

7. Migration certificate

8. Caste Certificate

9. Income Certificate

10. Non creamy layer certificate

11. Domicile Certificate

12. Affidavit (in case of change of Name)

13. Disability Certificate from disability Board

Date:_____________________

Place: ____________________ Signature of the candidate

“RAGGING IS TOTALLY BANNED AT BMHRC”


(21)

DECLARATION BY CANDIDATE

1. I hereby declare that the application filled in my own handwriting and all statements

made in it are true, complete, and correct to the best of my knowledge and belief and nothing

has been concealed. In the event of any statement being found false or incorrect or any

ineligibility being detected before or after the selection, action as such removal of my name

from the rolls and/or other action as may be considered necessary can be taken against me.

2. I also declare that I have carefully read the contents of the Prospectus in respect of the

course applied for and undertake to abide by the provision contained therein.

3. I further declare that I fulfill the all eligibility conditions regarding educational

qualification, experience etc. prescribed by the Institute for admission to the course applied for.

4. If selected and admitted to the course:

(a) I agree to work/undergo the course on regular basis.

(b) I shall not engage myself in any part time job/private practice during the course, if

found, my name may be struck off.

Place______________

___________________

Date_______________ Signature of applicant

DECLARATION BY THE PARENT /GUARDIAN

I hereby declare that I shall be responsible for timely payment of all dues to the BMHRC,

BHOPAL in respect of my son/daughter/ward (name ________________________) during

the period of his/her stay at the Institute until their dues is cleared.

Date: _________________

Place: _________________

Signature of Parent /Guardian

Name:___________________________

Relation with candidate______________


(22)

Annexure- II


ADMIT CARD

For Entrance Test of Nursing Courses - Session: 2015-16

1. NAME……………………….. Father’s Name……………………………

2. Roll No………………………(To be assigned by the Office)

3. Examination Centre: Bhopal Nursing College, Bhopal Memorial Hospital & ResearchCentre, Raisen Bypass Road, Karond, Bhopal – 462038

4. Course applied for (Please tick the appropriate Box)


Signature of the candidate Academic cell, BMHRC

INSTRUCTIONS FOR CANDIDATES

CANDIDATE MUST REPORT AT THE EXAMINATION CENTRE AT LEAST ONE HOUR

BEFORE THE SCHEDULED TIME OF START OF WRITTEN EXAMINATION

1. This admit card is subject to the condition that if ineligibility is detected at any stage, your

candidature will be cancelled.

2. Check your particulars in the Admit Card carefully. Error, if any should immediately be

reported to the Academic Cell, BMHRC, BHOPAL.

3. Blue/black pen will have to be used for writing/making responses

4. No entry to examination hall without admit card.

5. Cell phones, pagers, calculators and other electronic instruments are strictly prohibited.

6. Do not attempt to give or to obtain irregular assistance of any kind.

7. Do not carry any article, even envelope of admit card into examination hall.

8. Do not mark or write anything on question paper.

9. Any attempt remove pages from Question Booklet will be severely dealt with.

10. Copying or noting down questions is strictly prohibited.

11. Hand over the question paper and answer sheet to the Invigilator before leaving the

examination hall.

12. Improper conduct will entail expulsion.

Affixphotograph as

per instructionsin the prospectus

with date


(23)

Annexure- III

FORM OF CERTIFICATE TO BE PRODUCED BY OTHER BACKWARD CLASSES(OBC) APPLYING FOR ADMISSION TO CENTRAL EDUCATIONAL INSTITUTE

UNDER THE GOVERNMENT OF INDIA

(G.I., Dept. of Per. & Trg., OM.No. 36033/28/94-Estt.(Res), dated 02-07-1997)This is to certify that _____________son/daughter of ____________ of

village________District/Division __________in the ____________state _________ belongs tothe ______________community which is recognized as a Backward Class under:

*(i) Government of India, Ministry of Welfare, Resolution No. 12011/68/93-BCC(c), dated the10th September, 1993, published in the Gazette of India, Extraordinary, Part-I, Section 1, No.186, dated the 13th September, 1993.

*(ii) Government of India, Ministry of Welfare, Resolution No. 12011/9/94 -BCC, dated the19th October, 1994, published in the Gazette of India, Extraordinary, Part-I Section 1, No. 183,date3d the 20th October, 1994.

*(iii) Government of India, Ministry of Welfare, Resolution No. 12011/7/95-BCC, dated the24th May, 1995, published in the Gazette of India, Extraordinary, Part-I, Section 1, No. 88dated the 25th May, 1995.

*(iv) Government of India, Ministry of Welfare, Resolution No. 12011/44/96-BCC, Dated the6th December, 1996, published in the Gazette of India, Extraordinary, Part-I, Section 1, No.210, dated the 16th January, 2006.

Sh./Smt. _____________and or his/her family ordinarily reside(s) in the_____________District/Division of the ____________State. This is also to certify that he/shedoes not belong to the persons/sections (Creamy Layer) mentioned in Column 3 of theSchedule to the Government of India, Department of Personnel and Training, PM No.36012/22/93-Estt.(SCT), dated 08-09-1993 which is modified vide O.M. No. 36033/3/2004Estt.(Res.) dated 09.03.2004 or the latest modification of the Govt. of India.

(Seal) District Magistrate/Deputy CommissionerDate:Place:Note:

a. The term ‘Ordinarily’ used here will have the same meaning as in Section 20 ofthe Representation of the People Act, 1950.

b. The authorities competent to issue Caste Certificates are indicated below: (i)District Magistrate / Additional Magistrate / Collector / Deputy Commissioner /Additional Deputy Commissioner / Deputy Collector / Ist Class StipendiaryMagistrate / Sub-Divisional magistrate / Taluka Magistrate / ExecutiveMagistrate / Extra Assistant Commissioner (not below the rank of Ist ClassStipendiary Magistrate). (ii) Chief Presidency Magistrate / Additional ChiefPresidency Magistrate / Presidency Magistrate. (iii) Revenue Officer not belowthe rank of Tehsildar’ and (iv) Sub-Divisional Officer of the area where thecandidate and / or his family resides.


(24)

Annexure- IV

DECLARATION TO BE SIGNED BY OBC CANDIDATES ONLY

I, ____________________________daughter /Son/ Wife of

______________________resident of village/town/city ___________________ Dist.

_________________ state ______________ (certificate enclosed) hereby declare that I belong to

the ___________________ community which is recognized as a Backward Class by the Govt.

of India for the purpose of reservation in services as orders contained in Dept. of Personnel and

Training Office Memorandum No. 36012/22/93-Estt (SCT) DATED 8-9 -1993. It is also

declared that I do not belong to the persons/sections (creamy layer) mentioned in column 3 of

OM No. 36012/22/93-Estt (SCT) DATED 8-9-1993 and modified vide Govt. of India,

Department of Personnel and Training OM No. 36033/3/2004-Estt (Res) dated 09-3-2004.

Place:Date:

Signature of applicant

Note:The closing date for receipt of application will be treated as the date of reckoning for OBCstatus of the candidate and also for assuming that the candidate does not fall in the creamylayer. The OBC certificate submitted by the candidate shall be issued by the competentauthority within one year of the last date of submission of application.


(25)

Annexure- V

FORMAT FOR SC/ST CERTIFICATE

A candidate who claims to belong to one of the Scheduled Caste or the Scheduled Tribes should submitin support of his claim an attested/certified copy of a certificate in the form given below, from theDistrict Officer or the sub-Divisional Officer or any other officer as indicated below of the District inwhich his parents (or surviving parent) ordinarily reside who has been designated by the StateGovernment concerned as competent to issue such a certificate. If both his parents are dead, the officersigning the certificate should be of the district in which the candidate himself ordinarily residesotherwise than for the purpose of his own education. Wherever photograph is an integral part of thecertificate, the Commission would accept only attested photocopies of such certificates and not anyother attested or true copy. (The format of the certificate to be produced by Scheduled Castes andScheduled Tribes candidates applying for appointment to posts under Government of India) This is tocertify that Shri/Shrimati/Kumari* __________________________ son/daughter of___________________________________ of village/town/* in District/Division*_______________________ of the State/Union Territory* ________ belongs to theCaste/Tribes_______________ which is recognized as a Scheduled Castes/Scheduled Tribes* under:-The Constitution (Scheduled Castes) order, 1950 ___________________ The Constitution (ScheduledTribes) order, 1950 ________________ The Constitution (Scheduled Castes) Union Territories order,1951 * _______________ The Constitution (Scheduled Tribes) Union Territories Order,1951*______________ As amended by the Scheduled Castes and Scheduled Tribes Lists(Modification)order, 1956, the Bombay Reorganization Act, 1960 & the Punjab Reorganization Act, 1966, the State ofHimachal Pradesh Act 1970, the North-Eastern Area(Reorganization) Act, 1971 and the ScheduledCastes and Scheduled Tribes Order(Amendment) Act, 1976. The Constitution (Jammu & Kashmir)Scheduled Castes Order, 1956___________

The Constitution (Andaman and Nicobar Islands) Scheduled Tribes Order, 1959 as amended by theScheduled Castes and Scheduled Tribes order (Amendment Act), 1976*.The Constitution (Dadra and Nagar Haveli) Scheduled Castes order 1962.The Constitution (Dadra and Nagar Haveli) Scheduled Tribes Order [email protected] Constitution (Pondicherry) Scheduled Castes Order 1964@ The Constitution (Scheduled Tribes)(Uttar Pradesh) Order, 1967 @ The Constitution (Goa, Daman & Diu) Scheduled Castes Order, 1968@The Constitution (Goa, Daman & Diu) Scheduled Tribes Order 1968 @The Constitution (Nagaland) Scheduled Tribes Order, 1970 @The Constitution (Sikkim) Scheduled Castes Order 1978@The Constitution (Sikkim) Scheduled Tribes Order 1978@The Constitution (Jammu & Kashmir) Scheduled Tribes Order 1989@The Constitution (SC) orders (Amendment) Act, 1990@The Constitution (ST) orders (Amendment) Ordinance 1991@The Constitution (ST) orders (Second Amendment) Act, 1991@The Constitution (ST) orders (Amendment) Ordinance 1996 %%2. Applicable in the case of Scheduled Castes, Scheduled Tribes persons who have migrated from oneState/Union Territory Administration.

This certificate is issued on the basis of the Scheduled Castes/ Scheduled tribes certificate issued toShri/Shrimati ______________Father/mother _____________________________ ofShri/Srimati/Kumari*___________________________ of village/town*_______________________________ in District/Division* ______________________of the State/UnionTerritory*______________________________ who belong to the_________________________________ Caste/Tribe which is recognized as a ScheduledCaste/Scheduled Tribe in the State/Union Territory* issued by


the_______________________________ ____dated____________________________. %3.Shri/Shrimati/Kumari and /or * his/her family ordinarily reside(s) invillage/town*________________________________________ of ________________

(26)

District/Division* _________________of the State/Union Territory of ___________________Signature__________________________

** Designation______________ (with seal of office)Place______________Date_______________* Please delete the words which are not applicable @ Please quote specific presidential order % Deletethe paragraph which is not applicable. NOTE: The term ordinarily reside(s) used here will have thesame meaning as in section 20 of the Representation of the People Act, 1950.** List of authorities empowered to issue Caste/Tribe Certificates:

(i) District Magistrate/Additional District Magistrate/Collector/Deputy Commissioner/AdditionalDeputy Commissioner/Dy. Collector/Ist Class Stipendiary Magistrate/Sub-Divisional Magistrate/Extra-Assistant Commissioner/Taluka Magistrate/Executive Magistrate.(ii) Chief Presidency Magistrate/Additional Chief Presidency Magistrate/Presidency Magistrate.(iii) Revenue Officers not below the rank of Tehsildar.(iv) Sub - Divisional Officers of the area where the candidate and/or his family normally resides.

NOTE: ST candidates belonging to Tamil Nadu state should submit caste certificate ONLY

FROM THE REVENUE DIVISIONAL OFFICER.


(27)

Annexure- VI

ENDORSEMENT BY THE EMPLOYER, IF THE APPLICANT IS IN SERVICE

Dispatch No: _________________ Date________________

Forwarded to the Academic Cell, BMHRC, BHOPAL for

consideration. The undersigned has no objection to the applicant Ms./Mr

______________________ being considered by the Institute for the course applied for by

him/her and if selected, he/she will be relieved within, the prescribed time limit. The applicant

is ‘Sponsored’ by us and the sponsorship certificate is enclosed.

Address ____________________ (__________________)

___________________________ (Signature of employer)___________________________ with official seal


(28)

Annexure - VII

BHOPAL NURSING COLLEGE

Bhopal Memorial Hospital & Research Centre,

(Indian Council of Medical Research, Department of Health Research, Ministry of

Health & Family Welfare, Govt. of India).

Raisen Bypass Road, Karond, Bhopal – 462 038

Tel. No. 0755-2742279, 0755 – 2742212-16, Extn. 8803, 8821

MEDICAL EXAMINATION FORM

1. Student Name in full (in block letters) _____________________________

2. Date of Birth: ___________ Place of Birth: _______________Age:________ Sex: _____

3. Marital Status - Married / Unmarried ______________ No. of Children_______________

4. Category: (SC/ST/OBC/PH/General) _____________

5. Weight: ____________ Height: _________________ Vital Signs: __________

6. Have you ever had small-pox, intermittent or any other fever, enlargement or suppurationof glands, spitting of blood, asthma, heart disease, lung disease, fainting attacks, rheumatism,appendicitis ?

7. When were you last vaccinated?

8. Have you suffered from any form of nervousness due to overwork or any other cause ?9. Personal History: Diet: _____________ Smoking:_________ Other Habbits:____________

10. Have you been examined by a Medical Board before?

11. If answer to the above is yes, please state what Service / Services you were examined for?

12. Who was the examining authority?

13. When and where was the Medical Board held?

14. Result of the Medical Board’s Examination, if communicated to you or if known.

15. All the above answers are to the best of my knowledge belief, true and correct and I shallbe liable for action under law for any material infirmity in the information furnished by me orsuppression of relevant information. The furnishing of false information or suppression of anyfactual information would be a disqualification and is likely to render the candidate unfit foremployment under the Government. If the fact false information has been finished or thatthere has been suppression of any factual information comes to notice at any time during thetraining programme of a person, his/her training would be liable to be terminated.

Date:…………. Candidate’s Signature


(29)

Report of the Medical Board on _____________________________________________(Name of the Candidate)

PHYSICAL EXAMINATION1. General Development: Good Fair Poor

Nutrition: Thin Average ObeseHeight (without shoes) ______________________ Weight _________________Any recent change in weight? ____________Temperature ________ ºC Pulse ______/Min.Mark of Identification: I. _______________________________________________

II. ______________________________________________Girth of Chest:-a) (After full inspiration)b) (After full expiration)

2. Skin condition: Any obvious disease (Normal / Abnormal)3. Eyes: (1) Any disease

(2) Night Blindness(3) Defect in colour vision(4) Field of vision(5) Visual acuity(6) Fundus examination

Acuity ofvision

Naked eye Withglasses

Strength of glassesSp. Cyl. Axis

Distant Vision R.E.L.E.

Near Vision R.E.L.E.

Hypermetropia (Manifest)R.EL.E

4. Ears inspection ____________ Hearing Right Ear_____________ Left Ear___________-5. Glands ________________________________ Thyroid________________________6. Condition of teeth : Normal / abnormal7. ENT : Normal / Abnormal8. Lymph nodes : Normal / Abnormal9. Respiratory system: Does physical examination reveal anything abnormal in the respiratoryorgans? If yes, explain fully.

Inferences:Mr/Ms/Mrs _____________________________________________ is examined on

_____________ and found to be medically __________________ (Fit/ unfit).Name & Signature of the CMO with Reg. No: ______________________________Stamp:Place:Date:

Note : The Medical certificate should be obtained from Govt. Medical Officer.


(30)

Annexure- VIII

ANTI-RAGGING AFFIDAVIT BY THE STUDENTI,______________________(full name of student with admission registration/enrolment

member) s/o, d/o, Mr./Mrs./Ms.___________________ having been admitted to (name of the

institution) _________________________ have received a copy of the UGC Regulations on

Curbing the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called

the “Regulations”) carefully read and fully understood the provisions contained in the said

Regulations.

2) I have, in particular, perused clause 3 of the Regulations and am aware as to what

constitutes ragging.

3) I have also, in particular, presued clause 7 and clause 9.1 of the Regulations and am fully

aware of the penal and administrative action that is liable to be taken against me in case I am

found guilty of or abetting ragging, actively or passively, or being part of a conspiracy to

promote ragging.

4) I hereby solemnly affirm and undertake that:

a) I will not indulge in any behavior or act that may be constituted as ragging under clause 3

of the Regulations.

b) I will not participate in or abet or propagate through any act of commission or omission that

may be constituted as ragging under clause 3 of the Regulations.

5) I hereby affirm that, if found guilty of ragging, I am liable for punishment according to

clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken

against me under any penal law or any law for the time being in force.

6) I hereby declare that I have not been expelled or debarred from admission in any institution

in the country on account of being found guilty of, abetting or being part of a conspiracy to

promote, ragging; and further affirm that, in case the declaration is found to be untrue, I amaware that my admission is liable to be cancelled.Declared this________day of________month of ________year.

Signature of deponent

Name:

VERIFICATIONVerified that the contents of this affidavit are true to the best of my knowledge and no part ofthe affidavit is false and nothing has been concealed or misstated therein.Verified__ (place) __on this the__ (day) _of __(month), __(year)____

Signature of deponent

Solemnly affirmed and signed in my presence on this the (day) ___ of (month), ___ (year) ___after reading the contents of this affidavit.

Signature of Notary


(31)

Annexure- IX

ANTI-RAGGING AFFIDAVIT BY PARENT/GUARDIANI, Mr./Mrs./Ms._________________________________(full name of parent/guardian)father/mother/guarding of, (full name of student with admission/registration/enrollmentnumber) having been admitted to (name of the institution)___________________ havereceived a copy of the UGC Regulations on Curbing the Menace of Ragging in HigherEducational Institutions. 2009, (herein after called the Regulations”) carefully read and fullyunderstood the provisions contained in the said Regulations.2) I have, in, particular, perused clause 3 of the Regulations and am aware as to whatconstitutes ragging.3) I have also. In particular, presued clause 7 and clause 9.1 of the Regulations and am fullyaware of the penal and administrative action that is liable to be taken against my ward, in casehe/she is found quality of or abetting ragging, actively or passively, or being part of aconspiracy to promote ragging.4) I hereby solemnly aver and undertake that :

a) My ward not indulge in any behavior or act that may be constituted as raggingunder clause 3 of the Regulations.

b) My ward will not participate in or abet or propagate through any act of commissionor omission that may be constituted as ragging under clause 3 of the Regulations.5) I hereby affirm that, if found guilty of ragging, my ward is liable for punishment accordingto clause 9.1 of the Regulations. Without prejudice to any other criminal action that may betaken against me under any penal law or any law for the time being in force.6) I hereby declare that my ward has not been expelled or debarred from admission in anyinstitution in the country on account of being found guilty of, abetting or being part of aconspiracy to promote, ragging; and further affirm that, in case the declaration is found to beuntrue, I am aware that my son/daughter admission is liable to be cancelled.Declared this _____day _________ of month of ____ year.

Signature of deponentName :

Address :Telephone/Mobile No:

VERIFICATIONVerified that the contents of this affidavit are true to the best of my knowledge and no part ofthe affidavit is false and nothing has been concealed or misstated therein. Verified__ (place)__on this the__ (day) _of __(month), __(year)____

_________________Signature of deponent

Solemnly affirmed and signed in my presence on this the (day) _of __(month),__(year)____after reading the contents of this affidavit.

Signature of Notary


(32)

Annexure- X

BHOPAL NURSING COLLEGE

Bhopal Memorial Hospital & Research Centre, Bhopal

(Indian Council of Medical Research, Department of Health Research, Ministry of

Health & Family Welfare, Govt. of India).

Raisen Bypass Road, Karond, Bhopal – 462 038

Tel. No. 0755 – 2742212-160, 0755-2742279 Extn. 8803, 8821(Recognized by: Indian Nursing Council & MP State Nursing Council & Affiliated to

Barkatullah University, Bhopal (M.P.).

Admission for Girls Hostel Accommodation

ToThe Deputy Director Engineering ServicesBhopal Memorial Hospital & Research CentreBhopal.

Subject: requisition for Hostel accommodation in Girls Hostel, BMHRC, Bhopal.

I wish to reside in the Girls Hostel, BMHRC, Bhopal, kindly provide accommodation witheffect from ______________.

I solemnly declare that during my stay in hostel, I will abide the rules and regulation of theCollege hostel and as modified thereafter, or from time to time. Competent authority can takeany disciplinary action; if I fail to abide rules and regulations of the hostel.

Name & Signature of the Student Name & Signature of the parent

Permanent Address Local Guardian if any (Name & Address)

Note: Submit Parents or Local Guardian photograph with application form.___________________________________________________________________________

For office use only

Hostel accommodation is _________________________(allotted or not allotted) to -------------------------------------------- (Name of the student) with effect from __________________ inGirls hostel, BMHRC, Bhopal.

Signature of the Hostel Warden Signature of DDES

Self attested

Passport size

student’s photo


33


34