Regional Institute of Paramedical and Nursing Sciences

ADMISSION FORM FOR UG (B.Sc.N, B.Sc.MLT, B.Pharm, B.Sc.RIT, B.Optom)-(Only for Beneficiary State Nominees / PMSSS)

* indicates mandatory fields.

Form No: 2023-719

Date: 08-02-2023

Student Details

* Attach Passport size photo Max Size: 200kb Compress photo here


Supporting document should be enclosed

Details of Student's Parent

Permanent Address *

Correspondence Address (If differ from Permanent address) *

Same As Above

Educational Qualifications *

Sl.No Name of Exam. Passed Year of passing Name of Board/University Full Mark Marks Obtained Percentage Division/Grade

Subjectwise Performance in HSSLC (Science) or equivalent *

Sl No Subject Full Marks Marks Obtained Percentage
1 English
2 Physics
3 Chemistry
Aggregate percentage in four subjects (in EPCB/EPCM)
( Minimum requirement 50% for Gen & 45% for other categories )

Extra curricular Activities (if any):

Any Addiction (Tobacco/Alcohol/ Drugs of any kind): *

Hostel Accommodation require:*

Documents required for upload:
(PDF with max file size: 200kb )

Nomination/Allotment Order. *
Marksheet of HSLC or Equivalent Examination. *
Certificate of HSLC or Equivalent Examination. *
Marksheet of HSSLC or Equivalent Examination. *
Certificate of HSSLC or Equivalent Examination. *
Caste/Tribe Certificate.
Permanent Residential Certificate. *
Fitness form (PDF or DOC with max file size: 200kb ) *
Adhaar Card (If available).

(Note: All documents uploaded by the applicant should be produced in original as and when call for verification by the Institute.)

** Compress pdf here

Declaration by the student: *

I do hereby declare that the information furnished above are true to the best of my knowledge and in the event of any misinformation detected. I shall be liable to be punished under the Rules & Regulations laid down by the Institute.