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State of Rajasthan - Section

Section 7 in Rules for Admission to Various Medical Colleges in Rajasthan, 1987

7.

If for reasons to be recorded in writing the Admission Board suspects that a particular candidate has obtained a certificate by mis-representing facts, the matter will be referred to the concerned D.M. On the receipt of the enquiry report the Admission Board would take the final decision regarding the Admission of the candidate.Note. - Any person other than the parents of the candidates can become guardian, only if the parents of the candidate are not alive or have been declared insane.Application for Admission
Miniature (bust) size photograph of the candidate duly signedand attested by a Gazetted Officer by signing across it andputting his official stamp here. {|
For Photo
|}To,The Convener,Admission Board for Medical College of Rajasthan,SMS 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 of those that may hereafter be made by the admission of the College and its associated hospitals and I undertake that so long as 1 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.Yours faithfullyDated....... 1987Signature of the CandidateParticulars of the ApplicantName of the applicant................................................................................................Date of Birth................................................................................................................Age on 31st December, 1987 ..................................................................................(As per High School/Secondary Exam. 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..............................Relation...............................................................Occupation of Father/Guardian.....................................................................................If in service, Mention (a) Designation.........................................................................
(b)Name of office...................................................................
(c)Place...................................................................................
Monthly income .................... Pay .......................... Allowance ......................... Total ........................ Enrolment No. ............................If enrolled at the present in Rajasthan University .................. whether applying for any reserved seat, if so specify...................Signature of the CandidateI certify that the above statement is correct.Signature of the Person of Reputeand status with DesignationEducational Qualifications:
Year Name of Institution Place Class in which studied
1985-86      
1984-85      
1983-84      
1982-83      
1981-82      
1980-81      
1979-80      
1978-79      
1977-78      
1976-77      
1975-76      
1974-75      
Details of Passing Qualifying ExaminationSubject: Hr. Section Exam./Ten Plus two system 1st Year T.D.C.I SC/Pre-Med./Pre-Professional or B.Sc.
  Max. Marks Min. Marks Marks Obtained
Compulsory      
General English      
General Hindi      
Optional      
Physics      
Biology      
Bio-Chemistry      
Botany      
Zoology      
Total Marks in Optional Subjects      
Percentage of Marks      
In Optional Subjects      
Certificate of Eligibility For AdmissionCertificate [Under Rule 3(C)(ii)]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 and Shri/Kumari ........................ has studied for 5 years (at least) in a recognised educational institution in Rajasthan.Court SealDatedSignature of the District Magistrate/Addl. Distt. Magistrate/Sub-Divisional MagistrateorI certify that Shri/Kumari......................is the natural Son/Daughter (not adopted) of Shri/Shrimati......................and is bonafide resident of Rajasthan.Court SealDatedSignature of the District Magistrate/Certificate [Under Rule 3-C(iii)(a)]Certified that Shri/Shrimati..........................Father/Mother of Shri/Kumari......................serving or retired employee of (i) Government of Rajasthan including Officer of All India Service borne on the State Cadre of Rajasthan and has served for more than 3 years with the State Government.(Specify...............)DatedSignature of the Employer/Head of the Departmentwith Designation & Rubber StampCertificate [Under Rule 3-C(iii)(b)]Certified that Shri/Shrimati...........................Father/Mother of Shri/Kumari.................................serving or retired permanent employee of Government Undertaking/Corporation/Improvement Trust/Municipal Board/Panchayat 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 atleast three years service on the last date for submission of application in the year of admission. He is in service of the organisation (above mentioned) for more than 3 years.DatedSignature of the Employer/Head of the Departmentwith Designation & Rubber StampCertificate [Under Rule 3-C(iii)(c)]Certified that Shri/Shrimati.......................Father/Mother of Shri/Kumari ................................sewing or retired permanent employee of the University (Name..........) in Rajasthan or Secondary Board of Education, Rajasthan and was put in atleast three years service on the last date for submission of application in the year of admission.DatedSignature of the Employer/Head of the Departmentwith Designation & Rubber StampCertificate [Under Rule 3-C(iv)]I certify that Shri/Kumari..............................is a natural Son/Daughter of Shri/Smt.............................and his/her Father/Mother is serving in permanent capacity in Indian Defence Service/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.DatedSignature of Employer (with seal)Parents/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).