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fnaMksjh jksM] EgljQG] ukf'kd&422004 Dindori Road, Mhasrul, Nashik-422004

Tel : (0253) 2539303/288 Website : www.muhs.ac.in, E-mail : urd@muhs.ac.in,muhsurd@gmail.com

MkW- dkfynkl n- pOgk.k Dr. Kalidas D. Chavan

,e-ch-ch-,l@-] ,e-Mh- (U;k;oS|d'kkL_k) M.B.B.S., M.D. (Forensic Medicine).
dqylfpo Registrar

tk-dz-evkfofo$;qvkjMh$542 $2017 fnukad % 10$10$2017

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Maharashtra University of Health Sceinces (MUHS), Nashik State level
Research Conference 2017-18. (Interpathy :- Teacher Researcher)
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Registration & Abstract submission
on https://journal.muhs.edu.in
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MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK
fnaMksjh jksM] EgljQG] ukf'kd&422004 Dindori Road, Mhasrul, Nashik-422004
Tel : (0253) 2539301,303 Fax : (0253) 2539298
Website : www.muhs.ac.in, E-mail : urd@muhs.ac.in
Maharashtra University of Health Sceinces (MUHS), Nashik State level Research
Conference 2017-18. (Interpathy: - Teacher Reseacher)
la'kks/kd ukefunsZ'ku izi_k
Researcher Nomitaion Letter
(To be submitted within 7 days of online Registration & submission of Abstract)
1. Name, Postal Address and Contact details of College/Institute: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . .. . ………………………………………. . . . PIN
Telephone no.: (0 ). . . . . . . . . . . . . . . . . . . . . .Fax no.: (0 ). . . . . . . . . . . . . . . . . . . .
e-mail ID: . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . …..
2. Name of the Dean/Principal/Director: . . . . . . . . . . . . . . . . . . . . . . . . . …………….. . .
Mobile No.: . . . . . . . . . . . . . . . . . . . . . .e-mail ID:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. (i) College/Institute Registration Certificate no. and date (attach attested copy): . . . . . . .
(ii) MUHS affiliation letter no. and date (attach attested copy): . . .. . . . . . . . . . . . . . . . .
4. List of Participants
Sr Academic Name Research Title Registration fee
No Category payment details
1 Ph.D Student
2 Assistant Professor
Certified that the participants are the bonafide students of this Institute which is affiliated to
MUHS Nashik .
Certified that the above Research Projects are approved by Institutional Ethics Committee. It is
further certified that there are no conficting interest of the Research with any other Research Institute or
Person & Research is original. The research work submitted by the Post Graduate student is not the part
of his/her Post Graduate Dissertation Research work. The Registartion form, abstract duly signed by
the participating researchers are enclosed herewith.

Date: Sign of Dean/Principal/Director

Place: Name: . . . . . . . . . . . . . . . . . . . .
College SEAL Rubber Stamp

Copy submitted to :-
1. The Registrar, Maharashtra University of Health Sciences, Nashik
2. Dr Agnis Swami, Tehmi Grant Institute of Nursnig Education, Pune