| SANDRA SHROFF COLLEGE OF NURSING

Name of Applicant *

Date of Birth *

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Gender *

Phone *

Email *

Full name of Father’s / Guardian’s *

Full name of Mother’s

Nationality*

Category *

Permanent Address *

Same as Permanent Address

Correspondence Address

SSC Board / University *

SSC Passing Year *

SSC Percentage *

HSC Board / University *

HSC Passing Year *

HSC Percentage *

BSC Board / University *

BSC Passing Year *

BSC Percentage *

M.Sc. Nursing Programme (Select Any One) *

State Nursing Council Registration No.

Work Experience (Min 1 Year Clinical or Teaching )

MSC Addmission Form