Application For Od

KALOJI NARAYANA RAO UNIVERSITY OF HEALTH SCIENCES
: WARANGAL - 506 007 - TELANGANA STATE :
APPLICATION FORM FOR OBTAINING ORIGINAL DEGREE CERTIFICATE FOR PG COURSES ONLY
Course: Applied For: Ordinary / Earlier IN ADVANCE
No format other than this shall be used. Please read the instructions given in pages 3 & 4
before filling up. This application form may be down leaded by candidates through KNR UHS Website
No: http://knruhs.telangana.gov.in/
APPLICATION FOR ISSUE OF PERMANENT DEGREE CERTIFICATE FOR ALL PG COURSES IN

ADVANCE / POST CONVOCATION
(This is the prescribed application form for obtaining permanent degree certificate IN ADVANCE,
to be filled up and to be submitted to this university through the concerned principal, by all those candidates who
have passed their PG Degree/ PG Diploma / Super Specialty Degree Examinations between the last and forthcoming
annual convocation only)
01) Full Name of the Candidate : Please affix here

your latest
02) Surname of the Candidate: passport size
photograph with
03) Name of the Father / Mother of the Candidate: ____________
wearing of Apron
duly attested by
04) a) Permanent Degree / Diploma Certificate Ap plied for : ________________
the Principal
b) Month & Year of Passing:
c) Registered No. (H.T.No. )
d) College where Studied and passed
05) Details of Fee paid :
a) Amount: Rs. b) DD / Pay Order No.
c) Date : d) Name of the Bank :
e) Place :
FOR THE USE OF KNR UHS EXAMINATIONS WING
1) T R Page No. 2) Degree Certificate Sl.No.

3) Sl.No. & Page No. of the
Degree Issue Register ( IN ADVANCE of)
Submitted :
All the details have been verified. Demand Draft has been sent to the Finance Wing. Hence, the
Permanent Degree Certificate may be Issued - (IN ADVANCE).
Jr.Asst. Sr.Asst. Supdt. A.R D.R C.O.E

06) Details of Registration done with the state MCI/DCI/NCI :
a) Registration No: Temporary / Permanent:
b) Date of Registration: c) Place of Registration:
07) Full Postal Address for Communication and Dispatch of Certificate. (With PIN Code)
08) Telephone / Cell Phone No :

Email ID :
Place :
Date :
(Signature of the Applicant)
FOR THE USE OF PRINCIPAL ONLY
Certified that the details furnished above by Dr.

are verified and found correct. The Applicant has no dues to this College. Hence, there is no
objection for issue of Super Specialty Degree / PG Degree / PG Diploma / Ph.D. / UG Permanent
Degree Certificate to him / her.
Place :
Date :
(Signature of the Principal with office seal)

INSTRUCTIONS / GUIDELINES TO THE APPLICANTS
1) USE ONLY CAPITAL LETTERS.

2) All Applications must be routed through the Principal of the College where applicant has studied
and passed the PG Degree / PG Diploma / Super Specialty Degree Examination.
3) Column No.1 & 2 of the application Form: Full Name & Surname of the Candidate:
a) It should be written strictly as spelt in the UG Degree Certificate (by those who are applying for PG
Degree / PG Diploma / Super Specialty Degree Permanent Certificates Only).
b) In case of those who want to obtain the PG Degree/PG Diploma/Super Specialty Degree
Certificates as per the changed name/changed Surname, the Full changed Name must be written as
spelt in the TS Gazette/Proceedings of the KNR University of Health Sciences/Proceedings of
the Director of Medical Education, Telangana /Proceedings of the Director of Health,
Telangana and the copy of letters should be enclosed.
4) Column No.3 of the application Form: Name of the Father / Mother: It should be filled up only
by those who are applying for issue of the Permanent Degree certificate only (IN ADVANCE)
5) Column No. 4
(a) of the application form : Permanent degree Certificate Applied For: (IN ADVANCE)
Please specify whether apply for issue of MD/MS Degree/Diploma / MD(AYU) / MD(H) /
M.Sc.(Applied Nutrition) / MDS / M.Sc(N) / MPT / Super Specialty / MD(U) / PDF / M.Sc(M).
6) Passport Size Photographs:
a) One Photograph of wearing with apron should be affixed on the Application Form duly
attested by the Principal of the college where the applicant has studied and passed for
clear visible of Principal's of Signature and seal of the college.
b) Two Photographs should be kept in an envelope and is to be enclosed to the
Application.
7) Column No.5: Details of fee:
The amounts of Fee of the concerned courses are kept in University Website separately. The
fee should be pay in the form of demand draft in favour of Registrar, KNR University of
Health Sciences, Warangal, T.S payable at Warangal on any Scheduled Bank.
8) Column No.7 : Full postal permanent and Correspondence Address:
This is required by KNR UHS for clarifications if any.
9) Column No.8 :Tele / Cell Phone No:
This is required by KNR UHS for clarifications if any.
10) Filled in application forms should be sent to the "CONTROLLER OF EXAMINATIONS" KNR
University of Health Sciences, Warangal – 506 007, Telangana , India.
ENCLOSURES:
The following documents are to be enclosed.

1. Attested copies of Provisional Certificate of PG Course.
2. Those candidates who want to obtain their Degree Certificates as per the changed Name /
changed Surname should submit attested copy of T.S Gazette / Proceedings of KNR University of
Health Sciences, Warangal.
3. All enclosures must be securely tagged to the application.
4. Envelope containing 2 (TWO) Passport size photograph should be kept at the bottom of all the
enclosures.
5. Demand Draft for prescribed fee Should be drawn from any scheduled bank in the name of Registrar,
KNR University of Health Sciences, Warangal payable at Warangal.
6. There is no need to enclose a self-addressed envelope either with stamps or without stamps.
Note:
1. This Application form should not be used obtaining the permanent

UG/PG/Degree/Diploma/Super Specialty Degree certificates "IN-PERSON" or "IN-ABSENTIA" of
KNR UHS Annual Convocation.
2. The following Two Address slips are to be filled up by the applicant to which his/her permanent
Degree Certificate is to be dispatched. The candidates are requested to furnish the clear address
in which the certificate to the dispatched by University in the below:
Address For Communication:
To
Pin Code: Cell Phone No.
Address For Dispatch of Certificate:
To
Pin Code: Cell Phone No.

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KALOJI NARAYANA RAO UNIVERSITY OF HEALTH SCIENCES

: WARANGAL - 506 007 - TELANGANA STATE :

Course: Applied For: Ordinary / Earlier IN ADVANCE

APPLICATION FOR ISSUE OF PERMANENT DEGREE CERTIFICATE FOR ALL PG COURSES IN

01) Full Name of the Candidate : Please affix here

c) Date : d) Name of the Bank :

FOR THE USE OF KNR UHS EXAMINATIONS WING

1) T R Page No. 2) Degree Certificate Sl.No.

Jr.Asst. Sr.Asst. Supdt. A.R D.R C.O.E

a) Registration No: Temporary / Permanent:

b) Date of Registration: c) Place of Registration:

08) Telephone / Cell Phone No :

(Signature of the Applicant)

FOR THE USE OF PRINCIPAL ONLY

Certified that the details furnished above by Dr.

(Signature of the Principal with office seal)

1) USE ONLY CAPITAL LETTERS.

The following documents are to be enclosed.

1. This Application form should not be used obtaining the permanent

Address For Communication:

Pin Code: Cell Phone No.

Address For Dispatch of Certificate:

Pin Code: Cell Phone No.

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