All fields are mandatory

Please select the course
B.Sc., (Nursing)P.B.B.Sc.,(Nursing)M.Sc.,(Nursing)

Name of the Applicant

Specialty
Med.SurgOBGPsyPaedComm

Address to which Communications to be sent (With Pincode)

Landline Number

Mobile Number

Mail Id

Sex
MaleFemale

Name of the Father and Mother

Nationality

Religion
HinduChristianMuslimOthers

Community
SCSTBCBCMMBAOCOBCSCA

Date of Birth (DD/MM/YYYY)

Mother Tongue

Name of School/College last studied

Name of the University / Board

Month & Year of passing

Blood Group:

Provisional Degree Certificate No & Date:

Tamilnadu Nursing Council Number : RN, RM, Date

Experience Details: From date and To date, Place

Migration Certificate No & Date :

Eligibility Certificate No & Date:

Attach Documents

Mark list of SSLC

Transfer Certificate

Community Certificate

Migration Certificate

Aadhar card of student

Mark list of HSC (+2)/PDC/Intermediate