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Rajasthan Nursing Council, Jaipur B-39, Sardar Patel Marg, C- Scheme, Jaipur, Ph- 2222923 Application to the Registrar for Registration of Additional Nursing Qualification Applicant’s Details Candidate Name Father’s Name Date of Birth Sex Nationality Permanent Postal Address Additional Nursing Qualification Details Name of Additional Nursing Qualification Name of the Nursing School/College Period of training Name of Examination Body Details of Nursing Course Passed Name of the Course Name of the School/College Period of Training Name of Examination Body Nurse Registration Details Name of the Nursing Council Registration No. Registration Date I …………………………………………………………..hereby declare that the above details given are true to the best of my knowledge and belief. I pay herewith prescribed fee of Rs…………………. for registration of additional nursing qualification at Rajasthan Nursing Council, Jaipur. Jaipur Dated ……………………. Signature of the Candidate ……Instructions overleaf Passport size Photo of the applicant.

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  • Rajasthan Nursing Council, Jaipur

    B-39, Sardar Patel Marg, C- Scheme, Jaipur, Ph- 2222923

    Application to the Registrar for Registration of Additional Nursing Qualification

    Applicants Details Candidate Name

    Fathers Name Date of Birth

    Sex

    Nationality

    Permanent Postal Address

    Additional Nursing Qualification Details

    Name of Additional Nursing Qualification

    Name of the Nursing School/College

    Period of training

    Name of Examination Body

    Details of Nursing Course Passed

    Name of the Course

    Name of the School/College

    Period of Training

    Name of Examination Body

    Nurse Registration Details

    Name of the Nursing Council

    Registration No.

    Registration Date

    I ..hereby declare that the above details given are true to the best of my knowledge and belief. I pay herewith prescribed fee of Rs. for registration of additional nursing qualification at Rajasthan Nursing Council, Jaipur.

    Jaipur

    Dated . Signature of the Candidate Instructions overleaf

    Passport size Photo of the

    applicant.

  • Instructions

    1. The applicant must be registered with Rajasthan Nursing Council, Jaipur and have

    his/her active registration no as RN/RM.

    2. Registration fee of Rs.1000/- per additional nursing qualification is to be remitted in the

    form of Demand Draft drawn in the favour of Registrar, Rajasthan Nursing Council,

    Jaipur. Fee once deposited will not be refunded in any condition.

    3. In case of Registration of more then one additional Nursing Qualification different

    applications are required to be submitted.

    4. The additional nursing Qualification will be registered from basic to higher qualification

    in Systematic manner.

    5. The application must accompany the following certificates:

    a. Original Diploma/Degree certificate of additional nursing qualification with

    attested photocopy.

    b. Original Registration Certificate of Nursing Council with attested photocopy.

    c. Original marksheets of additional nursing qualification attested photocopy.

    d. Original of Diploma/Degree attested photocopy.

    e. Original secondary certificate (proof for Date of Birth) attested photocopy.