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State of Rajasthan - Section

Section 7 in Rules of Admission to Medical Colleges in Rajasthan, 1986

7.

If for reasons to be recorded in writing the Admission Board suspects that a particular candidate has obtained a certificate by misrepresenting facts, the matter will be referred to the concerned D.M. on the receipt of the inquiry report the Admission of the candidate.Note:- Any person other than the parents of the candidate can become guardian, only if the parents of the candidate are not alive or have been declared insane.Application For Admission
Space for photo   Miniature (bust) size photograph of the candidate duly signedand attested by a Gazette Officer by signing across it and puttinghis official stamp here.
To.The Convenor,Admission Board for Medical College of Rajasthan,S.M.S. Medical College, Jaipur.Sir,I have read the rules and regulations regarding Pre-Medical Test and Admission to the Medical Colleges. I declare that I am eligible for the same.I will/will not need hostel accommodation.I hereby agree, if admitted, to abide by the rules and regulations at present in force or those that here after be made for the administration of the College and its associated hospitals and I undertake that so long as I am a student of the College, I will do nothing either inside or outside the college that will interfere with its orderly working and discipline.I hereby declare that the entries in the application form are true to the best of my knowledge and belief. I further declare that if any entry in this form is later found to be incorrect, I shall abide by the decision (even the cancellation of my Admission) of the Admission Board.Date...........1986Yours faithfully.Signature of Candidate.Particulars of the ApplicantName of the Applicant....Date of birth....Age on 31st December. 1986............(As per High School/Secondary Examination Certificate).Father's Name .........Permanent Home Address of the candidate in full..........Address where the Parent/guardian of the candidate is employed/working........Postal address on which reply is to be sent............
Married or unmarried.............. Nationality.........
Religion and Caste...........  
Name of Guardian....... Relationship....
Occupation of Father/Guardian.........  
If in sendee, mention (a) Designation..........
(b)Name of Office
(c)Place
Monthly income......................Pay.................Allowance..................Total.......Enrollment No. if enrolled at present in Rajasthan University................Whether applying for any reserved seat, it so, specify.....Signature of the Candidate.I certify that the above statement is correct.Signature of personof repute and statuswith Designation.Educational Qualifications:-
Year Name of institution Place Class in which studied
1985-86      
1984-85      
1983-84      
1982-83      
1980-81      
1979-80      
1978-79      
1977-78      
1976-77      
1975-76      
1974-75      
Details of Passing Qualifying Examinations
Subjects:- Hr. Section Examination Tenplus two system 1st YearT.D.C./ISC/Pre-Medical/Pre-Professionalor B.S.C.
    Maximum Marks Minimum Marks Marks Obtained
1 2 3 4
Compulsory:      
English      
Hindi      
Gen.Education      
Optional:      
Physics      
Chemistry      
Biology      
Botany      
Zoology      
Total marks inoptional subjectsPercentageof marksin optional subjects      
Certificate of Eligibility for Admission Certificate[Under Rule 3 (a)]I certify that Shri/Kumari.............is the natural son/daughter (not adopted) of Shri/Shrimati................ and his/her/father/mother has continuously resided in Rajasthan for a period of last 10 years.
Court SealDate. Signature of the D.M./Addl. DistrictMagistrate/S.D.M
orI certify that Shri/Kumari...............is the natural son/daughter (not adopted) of Shri/Shrimati.................... and is a bonafide resident of Rajasthan.
Court SealDate. Signature of District Magistrate
Certificate [Under Rule 3 (a) (i)]Certified that Shri/Shrimati......................... father/mother of Shri/Kumari...............is serving or retired employee of (i) Government of Rajasthan including officers of All India Services, borne on the State Cadre of Rajasthan.(Specify ..............................)Signature of the Employer/Head of the Department withDesignation and Rubber Stamp.Dated...........Certificate [Under Rule 3 (a) (ii)]Certified that Shri/Shrimati..........'... father/mother of Shri/Kumari .............serving or retired permanent employee of Government Undertaking/Corporation/Improvement Trust/ Municipal Board/Panehayat Samiti/Co-operative bodies, duly constituted by the Government of Rajasthan or by an act of law or by Indian Company's Act, who has put in atleast 3 years service on the last date for submission of application in the year of admission.Signature of the Employer/Head of the Department withDesignation and Rubber Stamp.Dated......Certificate [Under Rule 3 (a) (iii)]Certified that Shri/Shrimati......................... father/mother of Shri/Kumari ............. serving or retired permanent employee of the University (name) ......... in Rajasthan or Secondary Board of Education, Rajasthan, and has put in atleast three years service on the last date for submission of application in the year of admission.Signature of the Employer/Head of the Department withDesignation and Rubber Stamp.Dated........Certificate [Under Rule 3 (a) (iv)]I certify that Shri/Kumari is a natural son/daughter of Shri/Shrimati.......... and his/her father/mother is serving in permanent capacity in Indian Defence Services/Central Government Service/Public Sector undertaking or Corporation of Government of India as..........and he/she is of Rajasthan origin and the home town as given by him/her at the time of his/her entry into service are .............Town..............Distt...State.Date.........Signature of Employer,with SealNote : Strike the portions not applicable.Certificate Regarding Migration From Burma/other CountriesI (Name of the Distt/Addl.Distt.Magistrate/S.D.M.) certify that Shri/Kumari........is the son/daughter of Shri. migrated to India during the last five years from on.............vide immigration certificate No dated............ and was registered at in Rajasthan vide Registration No.............Court SealDate.........Signature of the District MagistrateAddl. District Magistrate/S.D.M.Parent/Guardians CertificateI ... solemnly affirm that I am the natural father/mother of Shri/Kumari..........and my monthly income is Rs......orI solemnly affirm that Shri/Kumari is the son/daughter of Shri................ I am the guardian of Shri/Kumari as his/her parents have died/become insane. He/She is my........ (State relationship).