Prospectus & Application Form for Registration and Admission

 

This Prospectus contains an application form for Registration & Admission in a course. The complete application form along with necessary enclosures / documents must reach the Dean, Rajshree Medical Research Institute, 21st KM, NH-24, Bareilly Rampur Road, Village- Satuiya Khas, Tehsil- Meerganj, Bareilly (U.P.)

 

Instructions for Filling the Application Form
  •  Form must be filled in the candidate’s own handwriting with a blue/black pen.
  • Name of the Applicant: Write name in capital letters as neatly and legibly as it appears in your mark sheet of the qualifying examination.
  • Fill the form in English using capital letters, except for signature.
  • Name of the Parent / Guardian: Write the name of parent / guardian (Any person, other than the parents of the candidate, can become guardian only if the parents are not alive.)
  • Overwriting, cutting, erasing in the form may lead to rejection and should be avoided.
  • Any discrepancy in the statement and / or submission of incomplete forms will lead to rejection of application / cancellation of admission.
  • Date of Birth: Enter the date, month and year of birth as recorded in class10th certificate.
  • Address for Correspondence: Write the complete postal address including pin code on which the candidate is to be communicated. Also write the telephone number with STD / ISD code and Fax /E-mail address, if any.
  • Paste your recent photograph (not older than three months) at the appropriate place on the application. Photograph must be signed by the candidate at the edge.

 

Documents to be attached with filled in application form for MBBS Course
  • An attested photocopy of S.S.C (12th) Board Certificate
  • An attested photocopy of H.S.C (10th) Board Certificate
  • Bonafide and character certificate from the Principal of the School/College last attended
  • Entrance Examination Score Card
  • Migration Certificate/Transfer Certificate
  • Six recent Passport Size photographs
  • Aadhar Card
  • Seat allotment letter
  • Nationality and Domicile Certificate
  • Gap Certificate (if passed qualifying examination before the admission year.
  • Caste Certificate (only for SC/ST/OBC)
  • Income Certificate of Parent/Guardian
  • Address Proof
  • Declaration form as per prescribed format on a non-judicial stamp paper of Rs. 10/- duly attested by Notary Public
  • Anti-Ragging Form as per prescribed format on a non-judicial stamp paper of Rs. 10/- duly attested by Notary Public
  • Fitness Certificate from a registered medical practitioner

 

Documents to be attached with filled in application form for MD/MS Course
  • An attested photocopy of MBBS completion mark sheet
  • An attested photocopy of S.S.C (12th) Board Certificate
  • An attested photocopy of H.S.C (10th) Board Certificate
  • Bonafide and character certificate from the Principal of the School/College last attended
  • Entrance Examination Score Card
  • Undergraduate Degree
  • Undergraduate State Registration Certificate
  • Migration Certificate/Transfer Certificate
  • Seat allotment letter
  • Six recent Passport Size photographs
  • Nationality and Domicile Certificate
  • Gap Certificate (if passed qualifying examination before admission year)
  • Caste Certificate (only for SC/ST/OBC)
  • Income Certificate of Parent/Guardian
  • Address Proof
  • Copy of Aadhar Card
  • Copy of PAN Card
  • Declaration form as per prescribed format on a non-judicial stamp paper of Rs. 10/- duly attested by Notary Public
  • Anti-Ragging Form as per prescribed format on a non-judicial stamp paper of Rs. 10/- duly attested by Notary Public
  • Fitness Certificate from a registered medical practitioner