Orely RY . : 07652243001 f-a: deanshahdola gmial.

com
aT . : 07652-243111 duaTT : dean-gmcshahdol.mp.gov.in
sHiS/..1.6.a ITÀNAftoa/A A. 2023 TEBTa, fats :t.OM/2 023

17 3c 2023
27 3M 2023 A 05:00 a 5
01 HB, 2023 d 04 H, 2023

1 BACHELOR OF PHYSIOTHERAPY(DEGREE) 04 qt 50
2. BACHELOR IN MEDICAL LAB. TECHNICIAN (DEGREE) 03 gt 50
3. MEDICAL LAB. TECHNICLAN (DIPLOMA) 02 q 50
0.T. TECHNICIAN (CERTIFICATE) 01 g 30
4.

5. ANESTHESIA TECHNICIAN (CERTIFICATE) 01 q 30

gef qf
eT farfer
74510/- tefors N 5 745 10/- etocs lc5
55O00/ 74510/- Aterfocs CE 6 745 10/- terfojcs cC5

fUjes h
3 TetT 5 745 10/- rerfojes cC5 5 745 1 0/- refurcs Iccs5 745 10/-
5 50o0/

fardas fars
5 479g 10/- terfores ces
5 5000/

faras farjas
1 gsifa 34600/- tetocs c6 farias
5 5000/

3faarf ao
3fera gof 34ftcart fere 33 yfagra 3ic5 alal
ufaera i

CEO & DEAN

Govermant Medical College
Shshdol (M P)
 CREAMY
COLLEGE Ie Govemment
Aledical
College
I CEO
&
DEANShshdol
(MP)
zoT
NON MEDICAL
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frs 300/-(fta 2022 COLLEGE
ngftt JAT
5. MEDICAL
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LAYER/ 3Tdc5 "NEW
3.
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19. b13ffiu aics t HT 30Gazi gTT: 10:00 frG Gaut HGyfa aat 02 tt

I.

III.
IV.

VI.

VIII.
IX 10 qrau& I^ ài
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Govrase ro olege
 iSjkesfMdy ikB~;Øe gsrq vkosnu i= 'kS{kf.kd l=% 2022&23
izfr]
uohure ikliksVZ
eq[;dk;Zikyu vf/kdkjh ,oa vf/k"Bkrk]
lkbt QksVks pLik
'kkldh; fpfdRlk egkfo|ky;] 'kgMksy ¼e-iz-½
djsa
fMek.M Mªk¶V Øekad fnukad cSad dk uke jkf'k

1. Candidate’s Name in Capital Letter : ..............................................................................................

vkosnd dk uke Li"V v{kjksa esa ¼fgUnh esa½ : -------------------------------------------------
2. fyax ¼iq-@e-½ : ----------------------------------------------------------------------------
3. Category /Js.kh/ : (SC/ST/OBC/ UR/EWS )-----------------------------------------------
4. Father’s Name in Capital Letter: Shri ............................................................................................
firk dk uke ¼fgUnh esa½ % Jh --------------------------------------------------------------
5. Mother’s Name in Capital Letter: Smt. .........................................................................................
ekrk dk uke ¼fgUnh esa½ % Jherh ----------------------------------------------------------
6. tUe frfFk Date of Birth / : vadks esa : -------------------------------------(dd/mm/yyyy)
’kCnks esa % ---------------------------------------------------------------------------------
7. Permanent full address in capital letter : ---------------------------------------------------
-------------------------------------------------------------------------------------------
--------------------------------------------------------- Pin Code : ----------------------
iw.kZ LFkkbZ irk ¼fgUnh esa½ : -------------------------------------------------------------------
-------------------------------------------------------------------------------------------
-------------------------------------------------------- fiu dksM : -----------------------
8. orZeku irk fiu dksM lfgr : ---------------------------------------------------------------
-------------------------------------------------------------------------------------------
----------------------------------------------------------- fiu dksM : --------------------
9. vkosnd dk eksckby uEcj : -----------------------bZ&esy vkbZ-Mh- : --------------------------
10. vkosnd dk vk/kkj dkMZ ua- : ----------------------------------------------------------------
11. leXkz vkbZ-Mh- :-----------------------------------------------------------------------------
12. D;k vkosnd e-iz- dk ewy fuoklh gS\ : --------------------¼gka@ugha½ ;fn ugha rks jkT; dk
uke: --------------------------------------------------------------------------------------
13. D;k vkosnd 'kkldh; lsokjr deZPkkjh gS\ : -------------- ¼gka@ugha½ ;fn gkW rks foHkkx dk uke
%------------------------------------------------------------------------------------------
 14. 'kS{kf.kd ;ksX;rk (Educational Qualification):
Exam Board Roll No. Passing Subjects Total Out of Percentage
Passed Year Marks Marks
1 2 3 4 5 6 7 8
Physics
Chemistry
12th Biology
Total (PCB)
Total (All Subject)

15. fuEukafdr nLrkostksa dh vfHkizekf.kr Nk;kizfr layXu djsa :-

lR;kiu ¼gka@ugha@ykxw ugha½
izos’k lfefr
Ø- nLrkostksa dk fooj.k vH;FkhZ LØwfVuh
}kjk ¼ewy fVIi.kh
}kjk lfefr }kjk
nLrkost½

1. vkosnu ’kqYd & fMek.M Mªk¶V

2. 10oha cksMZ ijh{kk vadlwph

3. 12oha cksMZ ijh{kk vadlwph

4. LFkkukarj.k izek.k&i= ¼T.C.½

ekbXkzs’ku izek.k i=
5.
¼cksMZ@fo’ofo|ky; }kjk tkjh½

6. vk/kkj dkMZ
l{ke vf/kdkjh }kjk tkjh e-iz- ds
7.
ewy@LFkkuh; fuoklh izek.k i=
l{ke vf/kdkjh }kjk tkjh tkfr izek.k i=@
8.
bZ-MCY;w-,l- izek.ki= ¼vkjf{kr laoxZ gsrq½
orZeku foÙkh; o"kZ dk vk; izek.k i=
9.
¼vkjf{kr Js.kh ds vH;fFkZ;ksa gsrq½
fnO;kax izoxZ ds vH;kfFkZ;ksa dks l{ke
10.
vf/kdkjh }kjk tkjh izek.k i=
Gap Certificate
11. ¼;fn o"kZ 2022 ls igys 12 oha d{kk
mÙkhZ.k dh gS½
ewy fu;ksDrk }kjk tkjh vukifÙk izek.k&i=
12.
¼lsokjr vH;FkhZ gsrq½
 @@ ?kks"k.kk&i= @@
eSa ,rn~ }kjk ?kks"k.kk djrk@djrh gw¡ fd vkosnu&i= esa nh xbZ Ø- 01 ls 12 rd dh leLr
tkudkjh ,oa layXu nLrkost iw.kZr% lR; gSA lR;kiu i'pkr~ nh xbZ tkudkjh ,oa nLrkost vLkR; ik,
tkus ij esjk izos'k fujLr fd;k tk ldsxk RkFkk esjs f[kykQ oS/kkfud dk;Zokgh dh tk ldsxhA lkFk gh
bl laLFkk esa izos'k ds i'pkr~ ikB~;Øe vof/k rd vU; fdlh laLFkk@ fo'ofo|ky; esa fdlh Hkh ikB~;Øe
esa izos'k ugha ywaxk vkSj u gh vU; laLFkk ls 'kklu }kjk fdlh Hkh izdkj dh vkfFkZd lgk;rk dk ykHk
izkIr d:axkA ;fn esjs }kjk ,slk fd;k tkrk gS] rks esjs f[kykQ oS/kkfud dk;Zokgh dh tk ldrh gS ,oa
izos'k fujLr fd;k tk ldsxk] ftlds fy, eSa Lo;a mÙkjnk;h jgWwxkA

LFkku %&
fnukad %& vkosnd ds gLrk{kj
uksV %& vkosnd dks fofHkUu iSjkesfMdy ikB~;Øeksa gsrq i`Fkd&i`Fkd vkosnu djus dh vko’;drk
ugha gSA lHkh ikB~;Øeksa gsrq ,d gh vkosnu i= ekU; gksxkA

¼dk;kZy;hu mi;ksx gsrq½

gLRkk{kj LØwfVuh lfefr %&
1- ------------------------- 2------------------------ 3- ----------------

gLrk{kj izos’k lfefr %&

1- -------------------- 2- -------------------- 3- -------------------- 4- --------------------