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  • Rajiv Gandhi University of Health Science, Karnataka: Examination Application Form

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    Sagargn Sagar
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    This examination application form is for Sandhesh G N, a student at Bangalore Medical College & Research Institute, to take the Phase I M.B.B.S. (RS3) examination in June 2015. The form provides Sandhesh's personal details like name, registration number, date of birth, and addresses as well as the subjects - Anatomy, Physiology, and Biochemistry - he will be tested on. It also lists the fees to be paid, including an application processing fee of Rs. 200 and an exam fee of Rs. 4,500, as well as spaces for the principal's signature and other details to be filled out.

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    This examination application form is for Sandhesh G N, a student at Bangalore Medical College & Research Institute, to take the Phase I M.B.B.S. (RS3) examination in June 2015. The form provides Sandhesh's personal details like name, registration number, date of birth, and addresses as well as the subjects - Anatomy, Physiology, and Biochemistry - he will be tested on. It also lists the fees to be paid, including an application processing fee of Rs. 200 and an exam fee of Rs. 4,500, as well as spaces for the principal's signature and other details to be filled out.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    2 views1 page

    Rajiv Gandhi University of Health Science, Karnataka: Examination Application Form

    Uploaded by

    Sagargn Sagar
    This examination application form is for Sandhesh G N, a student at Bangalore Medical College & Research Institute, to take the Phase I M.B.B.S. (RS3) examination in June 2015. The form provides Sandhesh's personal details like name, registration number, date of birth, and addresses as well as the subjects - Anatomy, Physiology, and Biochemistry - he will be tested on. It also lists the fees to be paid, including an application processing fee of Rs. 200 and an exam fee of Rs. 4,500, as well as spaces for the principal's signature and other details to be filled out.

    Copyright:

    © All Rights Reserved
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    Rajiv Gandhi University of Health Science, Karnataka

    4th 'T' Block, Jayanagar, Bangalore-560041

    EXAMINATION APPLICATION FORM


    Eligibility of the candidate should be checked by the Principal
    Course :
    Examination:

    M.B.B.S. (RS3)-PHASE - I
    Jun-15

    Name of the College : BANGALORE MEDICAL COLLEGE & RESEARCH INSTITUTE, BANGALORE
    College Code:
    Register No. :

    M001
    14M5917

    Application No. :

    20150011324

    Date :

    06-06-15

    Candidate Name :

    SANDESH G N

    Group :

    SC

    Nationality :
    Quota : CET / MGT

    Date of Birth & Age :

    Gender : M

    Present Address &


    Tel No

    Permanent Address
    & Tel No

    I-Year
    Subject

    To Be Paid Fees
    Exam App
    Processing 200
    Fees

    Marks
    Card
    Fees

    QPCode

    ANATOMY-TP1

    1075

    ANATOMY-TP2

    1076

    PHYSIOLOGY-TP1

    1077

    PHYSIOLOGY-TP2

    1078

    BIOCHEMISTRY-TP1

    1079

    BIOCHEMISTRY-TP2

    1080

    300

    Actual Paid Fees


    Exam App
    Marks
    Processing
    _____ Card ______
    Fees
    Fees

    Exam
    Fees

    4500

    Exam
    Fees _____

    Conducted

    PDC+Convocation
    +Dessertion Fees 0

    Attended

    (Exam Fees is calculated for each


    appearing QPcode)

    PDC+Convocation
    Fine
    +Dessertion Fees ____ Fees ______

    Total
    Fees _______

    Fee Receipt No ______ Fee Receipt Dt ------------------------Remarks:


    Signature of the Student :
    Date : 06-06-15

    Signature of the Principal


    with college / seal

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