Section 11 in Rules of Admission to M.B.B.S Course to Medical Colleges in Rajasthan, 1985

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State of Rajasthan - Section

Section 11 in Rules of Admission to M.B.B.S Course to Medical Colleges in Rajasthan, 1985

11.

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 Form for Admission in Medical Colleges of Rajasthan Session 1985-86 Whether Applying for Any Reserved Seats Scheduled Caste/scheduled Tribes

(If so, specify)
Application Form No. .........	P.M.T. Roll No...............
Reg. No..............	P.M.T. Marks..................
Date of receipt ...........	Interview No .........
Applicant belongs toRajasthan State	Yes/No (if so specify)(Order of preference)

S.M.S. Medical College, Jaipur.........S.P. Medical College, Bikaner..........R.N.T. Medical College. Udaipur..........J.L.N. Medical College, Ajmer............Dr. S.N. Medical College, Jodhpur.........Name of Applicant Shri/Kumari........................(In block letters)

Father's Name............
Whether resident of Rajasthan.	Yes/No
P.M.T. Centre requested.............
(Mention Place).
FOR OFFICE USE ONLY

(Candidate should not write anything on this page)

1. Age on 31-12-1985	…..…...................
2. Applicant belongs to Rajasthan State.	Yes/No
3. Applicant belongs to SC/ST/Armed Personnel/Disabledcategory.	Yes/No
4. Qualifications
5. Percentage of marks in optional subjects of the qualifyingexamination.	…...........................
6. Remarks
7. Signature of Scruntiy Clerk	Signature of Scrutiny Officer
8. Decision of Selection Board	….........................

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 rales 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 rales 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...........1985.Yours faithfully.Signature of Candidate.Particulars of the ApplicantName of the Applicant....Date of birth....(Age on 31st December, 1985 Years Months)(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..........Religion and Caste............Name of Guardian..............Occupation of Father/Guardian.........If in service, 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, if so, specify........................Signature of the Candidate.I certify that the above statement is correct.Signature of person of repute and status with Designation.Note:- Any person other than the parents of the student, can become guardian only if the parents are not alive. Educational Qualifications:-

Year	Name of Institution	Place	Class in which studied
1984-85
1983-84
1982-83
1980-81
1979-80
1978-79
1977-78
1976-77
1975-76

Details of Passing Qualifying Examinations

Subjects:-Hr. Section Examination/Ten plus two system/1stYearT.D.C./ISC/Pre-Medical/Pre-Professional or B.S.C.
		MaximumMarks	MinimumMarks	MarksObtained
1	2	3	4
Compulsory:
GeneralEnglish
….................
GeneralHindi
….................
Optional:
Physics.
….................
Chemistry
….................
Biology
….................
Botany
….................
Zoology
….................
Total marks inoptionalsubjects
….................
Percentage of marksinoptional subjects
….................

Certificate of Eligibility for AdmissionI certify that Shri/Kumari.........is the natural Son/Daughter of Shri /Shrimati............ and his/her father/mother has continuously resided in Rajasthan for a period last 10 years and He/She has studied atleast for last, five years as a regular candidate in a recognised Educational Institution in Rajasthan.Signature of the D.M./S.D.M/Addl. District Magistrate.Date ................orCertified that Shri/Shrimati................... father/mother of Shri/Kumari................is an serving or retired employee of

(i)Government of Rajasthan including officer of All India Services born on the State Cadre of Rajasthan(Specify.......)

(ii)The undertaking/Corporation/Improvement Trust/Municipal Board/Panchayat Samiti/Co-operative bodies, duly constituted by the Government of Rajasthan (specify............)

(iii)Statutory body and Corporation formed under the Indian Companies Act incorporated in Rajasthan (specify............)

(iv)University (name)......................... in Rajasthan or Secondary Board of Education. Rajasthan: and has put in atleast three years service on 1st October of Admission, in any of the above bodies/services.

Signature of the Employer/Head of the Department withDesignation and Rubber Stamp.orI certify that Shri/Kumari.............is a natural son/daughter of Shri/Shrimati.......... and his/her father/mother is serving in Indian Defence Services/Central Government Service/Central Government/Public Sector undertaking or Corporation of Government of India as ......... and he/she is employee of Rajasthan, origin irrespective of his/her place of posting. The State of origin and the home town as given by him/her at the time of his/her entry into service is..........Date.........Signature of Employer,with Seal.Note:-Strike the portions not applicable.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).I undertake to be responsible for his/her conduct and for maintenance and pay regularly all his/her expenses during his/her stay at the institution.Date..............Signature and Addressof Parent/Guardian.Certificate of Principal of College Last AttendedI certify that Shri/Kumari......... son/daughter of Shri..... of my College has passed in all the subjects of the following examination with particulars noted against each:-

(i)Higher Secondary Examination under ten+two System and has secured..............marks.

(ii)1st Yr. T.D.C/I. Sc./Pre-Medical Examination with English, Physics, Chemistry (including Organic Chemistry) and Biology in the year............ and has secured marks in optional subjects (Physics, Chemistry and Biology) out of .... marks.

(iii)B.Sc. Examination with Chemistry, Zoology in the year and has secured marks in optional subjects (Physics,Chemistry, Botany, Zoology and Biology) out of marks.

He/She bears a good moral character.His/Her date of birth as entered in the High Schools/SecondaryCertificate is.......Date..........Signature of Principal withhis Official Stamp.Certificate Regarding Scheduled Caste/tribe(This certificate must be signed by an Officer not below the rank of District Magistrate/Additional District Magistrate/Sub-Divisional Magistrate of the District of which the candidate is a bonafide resident).I..............(Name of Distt. Magistrate/Addl.Magistrate (Distt.)/S.D.M.(Distt.) certify that Shri/Kumari......... is the Natural born (not adopted) son/daughter of Shri......... and belongs to..................(name of caste) by birth as notified as a Scheduled Caste/Scheduled tribe under Presidential order for the State of Rajasthan in.........district.Court SealDated...........Signature of the District Magistrate/Addl. District Magistrate/S.D.M.Scrutiny Sheet

1. Name of the Candidate;
2. Postal Address;
3. Do you belong to SC/ST/Migrants	Yes/No
IF YES, have you attached therequired certificate.	Yes/No
4. P.M.T.Roll No.(to be filled by University Staff)
5. Qualifying examination passed/appeared.
Name of Examination	Board/University	Year	Roll No.	Subjects Offered

6. How eligible(see rules)
3(a) (b)	(i)	(ii)	(iii)	(iv)	(v)
(Please tick the appropriate box)
7. Age as on 3-1-12-1981.
Date of Birth .......		Years	Months	Days

	Signature of the candidate
Remarks of Scrutiny Staff
	Signature

Office of the Principal ,S.M.S.Medical College and Convenor, Admission Board, JaipurInt. No..........S.No.............Reg. No..........Dated............Ref:- Your application for Admission to M.B.B.S. Course Session, 1985-86You are hereby required to appear before the Admission Board on.............. at 10.00 a.m,/2.00 p.m.. in the office of the under-signed at your expenses.Please note that this interview letter does not ensure admission. Please bring with you all the original certificates and other documents in support of your claim.Convenor.N.B.- Address overleaf must be filled and stamp affixed by the candidate.StampTo.Shri/Kumari ................................................From:-Despatcher,S.M.S.Medical College.Jaipur-4

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State of Rajasthan - Section

Section 11 in Rules of Admission to M.B.B.S Course to Medical Colleges in Rajasthan, 1985

11.