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    Msbnpe 123

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    Vishal Ingle
    The document is an application for a diploma examination from the Maharashtra State Board of Nursing and Paramedical Education. It contains personal details of the applicant such as name, date of birth, address, education qualifications, and course details.

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    © All Rights Reserved
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    Msbnpe 123

    Uploaded by

    Vishal Ingle
    71 views2 pages
    The document is an application for a diploma examination from the Maharashtra State Board of Nursing and Paramedical Education. It contains personal details of the applicant such as name, date of birth, address, education qualifications, and course details.

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    msbnpe123

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    The document is an application for a diploma examination from the Maharashtra State Board of Nursing and Paramedical Education. It contains personal details of the applicant such as name, date of birth, address, education qualifications, and course details.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    71 views2 pages

    Msbnpe 123

    Uploaded by

    Vishal Ingle
    The document is an application for a diploma examination from the Maharashtra State Board of Nursing and Paramedical Education. It contains personal details of the applicant such as name, date of birth, address, education qualifications, and course details.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    22/05/2023, 21:37 Online Application Printing

    MAHARASHTRA STATE BOARD OF NURSING AND PARAMEDICAL EDUCATION


    Directorate of Medical Education & Research, 4th Floor, St. George’s Hospital Compound,
    P. D’Melo Road, Near C.S.M.T., Mumbai – 400 001
    Print Date : 22/05/2023

    Application For Diploma of Examination

    The Registrar,

    MAHARASHTRA STATE BOARD OF NURSING AND PARAMEDICAL EDUCATION


    Directorate of Medical Education & Research, 4th Floor, St. George’s Hospital
    Compound,
    P. D’Melo Road, Near C.S.M.T., Mumbai – 400 001
    MUMBAI 400001

    Sir/Madam,

    I request you to register my name and other particulars as stated below in part.
    Section of the register maintained under Maharashtra Nurse's Act, 1966 and further to give me a certificate of
    registartion.

    Application Info
    Application Application Application
    : 20230009623 : 19-05-2023 :
    No. Date Type Diploma Examination Certificate

    PersonalInfo Details
    Prefix : Miss. First Name : Sakshi
    Middle Name : Gajanan SurName : Chavan
    Mother Name : Sushila Marrital Status : Single
    Gender : Female Nationality : Indian
    Caste : S.C Religion : Buddhists

    BirthInfo Details
    Date of Birth(dd/MM/yyyy) : 20-08-2001 Place Of Birth State : MAHARASHTRA
    Place Of Birth District : Akola Place Of Birth Taluka : Akola
    Place of Birth : akola

    PresentAddress Details
    Anand Nagar Hingna Road Near Bholenath
    Address : State : MAHARASHTRA
    Mandir Akola Akola Maharashtra 444004
    District : Akola Taluka : Akola
    Pin Code : 444000

    Permanent Address Details


    Anand Nagar Hingna Road Near Bholenath
    Address : State : MAHARASHTRA
    Mandir Akola Akola Maharashtra 444004
    District : Akola Taluka : Akola
    Pincode : 444000

    Additional Details
    Email ID : [email protected] Mobile No : 9422163910
    Telephone : Alternate Mobile No. :
    Aadhar Card No : Passport No :

    103.48.51.24/msb/(S(rtpc1peolgfyp44vfsf2gk0i))/Onlineregistrations/Reports/OnlineApplicationPrintingForm.aspx?Appl_id=Appl_id=313261 1/2
    22/05/2023, 21:37 Online Application Printing

    Educational Details
    AUXILLARY NURSE Date of obtaining
    Qualification : : 30-10-2021
    MIDWIFERY Qualification

    PreEducation Qualification Details

    Sr. No. Qualification Passing month Passing Year Board Total Marks Out Of Marks
    1 S.S.C MARCH 2017 MAHARASHTRA STATE BOARD 274 500
    2 H.S.C FEBRUARY 2019 MAHARASHTRA STATE BOARD 399 650

    Course Details
    Institute From where DR. VANDANTAI DHONE NURSING SCHOOL,
    : Region : Nagpur
    Appeared For Exam AKOLA
    Maharashtra State Board of Nursing and
    University : Grade : First Division
    Paramedical Education
    Exam held in the month : OCTOBER Exam held in the Year : 2021
    Theory Exam Passed
    Seat No. : 5905 Marks : 476
    (GNM/ANM/B.Sc.)
    Out Of : 500

    Sr.
    Institute Name Period From Period To
    No.

    1 DR. VANDANTAI DHONE NURSING SCHOOL, AKOLA 01/08/2019 30/10/2021

    Amount For this Application


    Total Amount : 750.00

    Date :

    Signature of the Applicant

    Print Back

    103.48.51.24/msb/(S(rtpc1peolgfyp44vfsf2gk0i))/Onlineregistrations/Reports/OnlineApplicationPrintingForm.aspx?Appl_id=Appl_id=313261 2/2

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