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State of Odisha - Section
Section 1st in The Orissa Homoeopathic Regulations, 1972
1st. Homoeopathic Examination
The Secretary to the State Homoeopathic Faculty, Utkal.I request permission to appear at the ensuing 1st Homoeopathic Examination for Licence of the State Homoeopathic Faculty, Utkal.The fee of Rs..........(......... ) only is forwarded herewith.Name in full (Block letters) ......Father's name...........Race and religion...........Homoeopathic Institute .........Date of passing the Preliminary Examination (or any equivalentExamination, state name of Examination)............Permanent address...........Date of application.........Signature of candidate..........Note-Re-examination fee is.........| Serial No. | Roll No. | Written100 | Oral and Practical100 | Total |
| 1 | 2 | 3 | 4 | 5 |