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No of Candas z course Beaminaon Foe | ryt amount rer [over | meer [teat exe ome ae 350000 INTERNE 22000 DEMAND DRAFT DETANLS cast ‘SeNo. | BankName DDN Date | Amount 2000 x 500) x 200 % 100 ; 50 NOTE: Form tobe filed in Capital Letters only. 2, Draft should be in the Name of "SECRETARY, U.P. STATE MEDICAL FACULTY, LUCKNOW". 43. Enclose the List of Candidates. SEAL& SIGN. PRINCIPAL/ DIRECTORU.P. NURSES & MIDWIVES COUNCIL, LUCKNOW (NURSING REGISTRATION FEES FORM) FOR OFFICE USE ONLY DATE = TEETH BATCH: Month Year, TA ‘CENTER CODE ‘CENTER NAME ‘CONTACT PERSON CONTACT NO. Course No.of | Registration Fee | Registration Fee | Smartcard Fee | SmartcardFee | y.4Amount Candidates | (Per Candidate) | Amount | (Per Candidate) | Amount as nM. 7000.00 75000 “ANM 1000.00 250.00 DEMAND DRAFT DETAMS cast S.No. | Bank Name DD No. Date | Amount % 2000) x 500 1 ¥ 200 x 100 x 50 2 Kw [NOTE-t. Fill the Form in Capital Letters only. 2. Draft should be in the Name of “REGISTRAR, U.P. NURSES & MIDWIVES COUNCIL, LUCKNOW ~, 3. Enclose the List of Candidates. SALA SIGN. PRINCIPAL/ DIRECTORU.P. STATE MEDICAL FACULTY, LUCKNOW A (PARAMEDICAL EXAMINATION FEES FORM) rragaaaceUSeONTr BATCH: Month Yer ae [cewren cove =r | CENTER NAME CONTACT PERSON CONTACTO. a ae a ica [roar] Toa | welts wr or ete eee 6 Seer ee 00 Seong aa TO zee eer sa Soe soles Sasa es faecal = Read otic eal ase Seer ee on aces = aaa aa eT 2008 Sr ers 6 heiatinteaerattoee ares 2st Ser si Raa Ti =a ia aac ase am ccmaer eTE Ty See ee = aa ain aS 7 pasa eae eres za Sac ary a aa ea 00 eiiaenene 25000 aa ART 250000 aunt 00 acai eis retry eae = Saree 00 ana Eine Se aaa = Se err zs aaabies SEARS DRAFT OETA cas S| ation a a Tes sa ‘Torat Bnae i : 7) ear rs [NOTE: 1 Fille Form in Capital Letters only. 2. Draft shouldbe In the Name of SECRETARY, U.P. STATE MEDICAL FACULTY, LUCKNOW Salas the List of Candidates. PRINCIPAL/ DIRECTORU.P. STATE MEDICAL FACULTY, LUCKNOW (NEW ENROLLMENT FEES FORM) FOR OFFICE USE ONLY are: BATCH: Month Year. — Date ‘CENTER CODE ‘CENTER NAME ‘CONTACT PERSON ‘CONTACT NO. Near) Eatin Smart] Brain courses cabot, | card tee Feo | Total Amount (fer Candidate) | (Per Candidate) DIPLOMA N ACUPUNCTURE: 250.00 2500.00 DIPLOMA IN ANASTHESIA AND CRITICAL CARE TECHNTCIAN 250.00 2500.00 DIPLOMA N AUDIO AND SPEECH THERAPY TECHNICIAN 25000 750000 DHFLOMAT Ce TEERNTGAN AND TUBERCULOSIS PROGR Pr aaa DIPLOMA IN BL:DOD TRANSFUSION TECHNICIAN 75000 3500.00 DIPLOMA IN BURN AND PLASTICSURGENY TECHNICIAN 25000 2500.00 DIPLOMA IN CT, SCAN TECHNICIAN 250.00 2500.00 DIPLOMA IN CARDIOLOGY TECHNICIAN 7250.00 2500.00 DIPLOMA IN CLINICAL AND THERAPGUTIC NUTRITIONIST COURSE 250.00 2500.00 DIPLOMA IN DIALYSIS TECHNICIAN 750.00 2500.00 DIPLOMA IN EMERGENCY & TRAUMA GARE TECHNICIAN 2.00 2500.00 DIPLOMA IN HOSPITAL AND DOMICILIARY CARE ASSITANT 250.0 2500.00 DIPLOMA IN HOSPITAL RECORD KEEPING 250.00 250000 DIPLOMA IN INTERVENTION RADIOLOGY 250.00 250000 DIPLOMA IN LAB TECHNICIAN 250.00 250000 DIPLOMA NM. TECHNICIAN 250.00 250000 DIPLOMA IN MEDICAL TRANSCRIPTION AND TYPING 250.00 2500.00 |[DIPLoma in MINIMAL ACCESS SURGICAL TECHNICIAN 250.00, 500.00 DIPLOMA IN NEONATAL CARE TECHNICIAN 250.00 250000 ‘DIPLOMA I 0.7. TECHNICIAN 750.00 2500.00 DIPLOMA IN OFTOMETRY 250.00 2500.00 DIPLOMA IN OFTOMETRY (BRIDGE COURSE) 25000 2500.00 DIPLOMA IN ORTHOPAEDIC AND PLASTER TECHNICIAN 250.00 2500.00 DIPLOMAIN ORTHOPTICS 250.00 2500.00 DIPLOMA IN ORTHOTIC AND PROSTHETIC TECHNICIAN 25000 2500.00 DIPLOMA IN PHYSIOTHERAPY 750.00 2500.00 ‘DIPLOMA IN RADIO THERAPY TECHNICIAN 250.0 2500.00 DIPLOMA IN RESPIRATORY TECHNICIAN 25000 2500.0 DIPLOMA IN SANITATION 250.00| 2500.00 DIPLOMA IN XRAY TECHNICIAN 250.00 2500.00 ‘CERTIFICATE IN BABY NURSING & CHILD CARE 250.00 300.0 ‘CERTIFICATE IN EMERGENCY & TRAUMA CARE ASSISTANT 250.0 2500.00 NNER TS pe See ean > Pree en courses calc, |“ tnronment’ | Fearotmentsoer | gar cf ane | “Mataign Ft | rot Amount smartcard fee Card Fee (Por Camaidate) ‘amount cum 30000 3500.00 oo 50000 3500.00‘DEMAND DRAFT DETAILS cast ‘Sr.No. | Bank Name DD Ne. Date | Amount 2000 500) x 200 100 x80 x NOTE- 1. Form tobe filed in Capital Leters only. 2. Draft should be in the Name of "SECRETARY, U.P. STATE MEDICAL FACULTY, LUCKNOW". 3. Enclose the List of Candidates SEAL &SIGN. PRINCIPAL/ DIRECTORU.P. STATE MEDICAL FACULTY, LUCKNOW bo (PARAMEDICAL REGISTRATION FEES FORM) rex onsiaaaa dis BATCH: Mon fe. carro aa CENTER CODE —_, CENTER NAME CONTACT PERSON CONTAGTNO. ome cant | “teen | Reitaton | *Foc(rr| cartes | Tot Amount conte) cones | Soest RinikioneTae sito 5000 Sri W peers GFL at THOROEAN 51000 25000 090 ae ANTE TECNG 150.00 73000 Sea RCRA SO — a SEES REAR 150000 25080 Se 150000 25000 agree 150009 25000 re cur Tce 15000 25000 Ere ATTENTION ae a core tsr000 25000 prin oencenr aa GATTO T0000 25000 RN re aaLAR OBEAANTOT 150000 5000 oLeererrd 15000 25000 Sms NTN ELAR 151000 25000 aan ‘ona 25000 Serene 151000 2000 Pe THOT ‘50800 25080 prLoM nen ACESS TEOIGI 150000 7000 pron peak AE THC 750000 5000 Srna Tecan "5000 2soa0 aera 150000 25000 aaa aT 10000 2500 Dr OETA RAHA TEORG 10000 25000 aaa wereres 150000 25000 onl ea ear ael son00 25000 alpen tst0.00 25000 rin wa enor Tea Taso 25000 Rae ‘sono 000 Sia NTT T5000 200 ona AAFC 150800 2000 earache ne TE 000 7000 Seminar aT is0n00 2000 DEMAND DRAFT DETAILS casi se [ sake oo tas | amoawe Te : x 200 rec) 10 * x 10 TOTAL aie: is es NOTE: 1 Fille Form in Capital Leters only. 2 raft shouldbe inthe Name of "SECRETARY, U.P. STATE MEDICAL FACULTY, LUCKNOW” 5. Bcose the List of Candidates. SEALESICN PRINCIPAL/ DIRECTORU.P. STATE MEDICAL FACULTY, LUCKNOW (NURSING/PARAMEDICAL AFFILIATION FEES FORM) FOR OFFICE USE ONLY DATE FY:20__To 20__ TEETH OE (CENTER CODE 3 ‘CENTER NAME LCONTAGEEREON CONTACT NO. {AURILIARY NURSE & MIDWIFE 1, (FEMALE) ‘DIPLOMA GENERAL NURSING & MIDWIFERY ae DIPLOMA W ACUPUNCTURE 15,0000, ‘DIPLOMA W ANASTHESTA AND CRITICAL CARE TECINIGIAN 45,000.00, ‘DIPLOMA WN AUDIO AND SPEECH THERAPY TECINICIAN 1590000 ‘DIPLOMA W BCE TECHNICIAN AND TUBERCULOSIS PROGRAM MANAGEMENT 1500000 ‘DIPLOMA W BLOOD TRANSFUSION TECHNICIAN 1500000 ‘DIPLOMA 1 BURN AND PLASTICSURGERY TECHNICIAN 1500000 ‘DIPLOMA ICT. SCAN TECHNICIAN 1500000, DIPLOMAIN CARDIOLOGY TECHNICIAN 1500000) DIPLOMA IN CLINICAL AND THERAPEUTICNUTRITIONIST COURSE 1500000 DIPLOMA I DIALYSISTECHNICIAN 1500000, DIPLOMA IN EMERGENCY & TRAUMA CARE TECHNICIAN 1590000, DIPLOMA I HOSPITAL AND DOMICLIARY CARE ASSITANT 15,000.00 ‘DIPLOMA IN HOSPITAL RECORD KEEPING 15,000.00 ‘DIPLOMA IN INTERVENTION RADIOLOGY 35,000.00 DIPLOMA LAB TECINICAN 1500000 DIPLOMA MARL TECHNICIAN 7500000 DIPLOMA MEDICAL TRANSCRIPTION AND TYPING 1500000 DIPLOMA MINIAL ACCESS SURGICAL TEGHNICAN 1590000, DIPLOMA NEONATAL CARE TECHNICIAN 75000.00, DIPLOMA OT TECHIICIAN 3590000, ‘DIPLOMA WN OPTOMETRY 3590000 ‘DIPLOMA W\ OPTOMETRY (ORIDGE COURSE) 3500000 ‘DIPLOMA I ORTHOPAEDICAND PLASTER TECHNICIAN 1500000 DIPLOMA IN ORTHOTICS 7500000 DIPLOMA ORTHOTIGAND PROSTHETICTECHNICIAN 1500000 DIPLOMA. PHYSIOTHERAPY 5.00000 ‘DIPLOMA W RADIO THERAPY THCHNICIAN 1500000 DIPLOMA IN RESPIRATORY TECHNICIAN 1500000 IFLOMA IN SANITATION 15,000.00 OMA IX RAY TEGINICAN | Paramedical Certificate Courses DEMAND DRAFT DETAILS sen [ Bank name DON. ‘ae | Amount 200 500 1 | x 200 1300 A x foals Bias psd é NOTE: 1.Fil the Form in Capital Letters only. 2. Draft shouldbe inthe Name of SECRETARY, U.P. STATE MEDICAL FACULTY, LUCKNOW". 5 Bnelose the List of Candidates. PRINCIPAL/ DIRECTOR