FORM NO. 2
Sr. No.........................
APPLICATION-CUM-ADMISSION FORM FOR ADMISSION TO BAMS COURSE
SESSION 2014-2015 IN RAJIV GANDHI GOVT.
POST GRADUATE AYURDEDIC COLLEGE, PAPROLA, (KANGRA) 176115
(To be submitted by the Candidate at the time of counselling)
(Not to be filled by the Candidate)
--------------------------------------------------------------------------------------------------------------------------------------Order of Scrutiny Committee:
(i)
Eligible / Ineligible........................................................ ...................
(ii)
Category …………………….Covered under………………………….
(iii)
Group..............................
Covered under………...........................
Deficiencies if any ;
1.
...............................................
2.
...............................................
3.
...............................................
Full Signature of Scrutiny Committee Member (s)
Affix your latest
Passport size
photograph duly
attested by the
Gazetted officer
1. .............................. 2. .................................... 3. .................................... 4. ....................................
-------------------------------------------------------------------------------------------------------------------------------------------(To be filled by candidate in his/her own hand writing)
1.
Name of the candidate (in Block Letters)......................... ...................................................................
2.
Father’s Name (in Block letters)...........................................................................................................
3.
Guardians Name (if applicable)...........................................................................................................
4.
Result of BAMS Entrance Test 2014: (i)Roll No.................................(ii)Marks obtained.....................
(iii) Combined General Merit Rank………………… (iv) Category Merit Rank…………………………
5.
Category applied for:
(i)
Group l
(General/SC/ST/OBC/Backward Area/ ....................................................
Child of Ex-Servicemen/Child of Defence ..............................................
Personnel/Ward of Freedom Fighter/Physically Handicapped ..................
(ii)
Group III
(General/SC/ST)............................ .......................................................
6.
Examination Centre appeared: (Dharmshala/ Hamirpur/ Mandi/ Shimla).............................................
7.
Sex: Male/Female.................................................... 8. Date of Birth................................................
9.
Age as on 31st December, 2014................................... Years....................... Months................ days
10.
Are you bonafide Himachali / Domicile of Himachal Pradesh (Yes/No)............................................
11.
Address for correspondence (in block letters).................................................................................
..................................................................................................................................................
..........................................................................................................Pin Code..........................
Tel No.(with STD Code) .......................................................Mobile No..........................................
Permanent Home address (in block letters)....................................................................................
..................................................................................................................................................
..........................................................................................................Pin Code..........................
12.
Tel No.(with STD Code) .......................................................Mobile No..........................................
13
Have you passed two examination out of the following from the recognised School situated in backward areas of the
State of Himachal Pradesh (i.e Primary/Middle /Matric / 10+2) (Yes / No) ..............................
(For Backward Area Candidates only)
Examination
Sr.No.
Name of School with Tehsil and Distt.
Name of Board/ niversity
Passed
1.
Primary
2
Middle
3
Matric
4.
10 +2
14.
Details of marks obtained in qualifying examinations (10+2) and also mention the name of the qualifying
examination .........................................
Subject
Maximum Marks
Marks Obtained
Percentage
obtained
of
Marks
English
Biology
Chemistry
Physics
Total
Marks
obtained
Sanskrit
Exam
applicable)
15.
in
(If
Details of other equivalent qualifying examinations passed and also mention the name of the qualifying
examination (if applicable)................................................................
Examination Passed Subject
Marks
Max. Marks
with
percentage
16.
Board
University
/
Important documents to be attached with this form at the time of Counselling:
i)
A certificate of having passed qualifying examination (10+2) or equivalent as per eligibility conditions.
ii)
Matriculation/Higher Secondary Part-l / Indian School Certificate showing the date of birth. No
other certificate in respect of date of birth will be entertained.
iii) A latest certificate of good conduct and character from the Principal of the School/College
where the candidate studied last and from the Executive Magistrate (Tehsildar) not earlier than Six
months.
iv) Certificate of passing the Primary, Middle, Matric & +2 School Examinations from the recognised
institutions showing the place of institution located in the backward area(s) in the State of H.P. (in
case of Backward Area Category).
v)
Certificate of passing the 10+2 or equivalent examination or B.Sc Degree if applicable from the
recognised institutions showing the minimum eligibility of securing 50% (or 40% in case of
SC/ST/OBC) as the case may be in Physic, Chemistry, Biology.
vi) H.P.Bonafide certificate as per format given in Appendix A-l
vii) SC/ST/OBC/Children of Ex-servicemen/Defence Personnel./Ward of Freedom
Fighter/ Backward
Area/Physically Handicapped certificate as per format given in Appendix A-2 to A-8
viii) Any other certificate you deem fit to be attached.
ix)
Bring the original certificates alongwith one attested Zerox copy of each certificate at the time of
counselling.
x) Admit card.
Note:
The Physical Fitness certificate as per appendix A-9 and anti-ragging affidavit & undertaking as per
Appendix A-10 & A-11 shall be submitted by the candidates as recommended by the Counseling
Committee on the day of admission.
I certify that particulars as furnished by me as above are correct and are strictly as filled in
online Application Form. In case any of them is found false, my candidature is liable to be cancelled
and I shall have no claim for admission to the college on the basis of competitive test.
Signature of the applicant
Place:_____________________.
Dated: ___________________
I/We hereby certify that the above statement of particulars is true.
Signature of the Parents/Guardians
Signature of the Attester with Seal
FORM NO. 3
HIMACHAL PRADESH UNIVERSITY,
SUMMER HILL SHIMLA-5
FORM FOR APPLYING FOR BHMS COURSE AT
SOLAN HOMOEOPATHY MEDICAL COLLEGE & HOSPITAL, SOLAN (H.P.)
ALONG WITH PHOTOCOPIES OF APPLICABLE DOCUMENTS
SESSION 2014-2015
(NOTE: THIS FORM IS TO BE SUBMITTED BY THE DESIROUS CANDIDATES TO THE PRINCIPAL, SOLAN
HOMOEOPATHY MEDICAL COLLEGE & HOSPITAL, KUMARHATTI, DISTT. SOLAN (H.P.) – 173229).
-------------------------------------------------------------------------------------------------------------------------------------------1.
Name of the candidate (in Block Letters)...................................................
2.
Father’s Name (in Block letters)..................................................................
3.
Result of BAMS/BHMS Entrance Test 2014: (i)Roll No...........................
(ii) Marks obtained.............
(iii) Combined General Merit Rank…………………(iv) Category Merit Rank…………………………
4.
Category .................................................................................................
5.
Sex : Male/Female ............................ Date of Birth....................................
6.
Age as on 31st December 2014.............................. Years....................... Months.................... days
7.
Are you bonafide resident/Domicile of Himachal Pradesh (Yes/No),................................................
8.
Details of marks obtained in qualifying examinations (10+2) and also mention the name of the qualifying
examination .....................
9.
Details of marks obtained in qualifying examinations (10+2) and also mention the name
qualifying examination .........................................
Subject
Maximum Marks
Marks Obtained
of the
Percentage of Marks
obtained
English
Biology
Chemistry
Physics
Total
Marks
obtained
in
Sanskrit in Matric (If
applicable)
10.
Address for correspondence (in block letters).................................................................................
.................................................................................................................................................
..............................Pin Code..................... Tel No.(with STD Code) ..............................................
11.
Permanent Home address (in block letters)....................................................................................
.................................................................................................................................................
.......................................................Pin Code..............................................................................
Signature of Parents
Note:
Signature of Candidates
This form be submitted to the Principal Solan Homoeopathy Medical College, Solan by the
Candidate desirous to take admission in above College on the basis B.A.M.S./B.H.M.S.
Entrance Test 2014 so as to reach them by 19.08.2014.
Dates for holding of Counselling for BHMS at Solan Homoeopathic Medical College &
Hospital, Bye-Pass Road, Kumarhatti, Distt. Solan, H.P.
i) For State Quota Seats
ii) For Management Quota Seats
21.08.2013 at 11:00 a.m
22.08.2013 at 11:00 a.m