::KNIMT: Faculty of Nursing, Sultanpur U.P.

Basic Details :
Name		Your Image (Max. 50kb Size of JPG File)	File Size:
Gender		Course Applied For
DOB	Your Age(as on 31 Dec 2021) : 0	If you age is less than 17 then you do not fulfill the eligibility of age criteria. Please do not fill the form.
Domicile		Aadhar Number
Father's Name		Mother's Name
Category		Religion
Personal Mobile No.		Parents Mobile No.
Whatsapp No.		Email
Communication Address		Permanent Address
Qualifying Details:
Qualifying Examination 10+2(Intermidiate)		Qualifying Exam Board
Stream		Status
Qualifying Exam Roll No.		Passing Year if already Passed else write Appearing
Marks Obtained If Appearing write NA		Maximum Mark If Appearing write NA

I hereby declare that all the particulars furnished in this application are true, correct and complete to the best of my knowledge and belief. In the event of any information being found false or incorrect or ineligibility being detected before or after the Admission Process, action can be taken against me by the KNIMT, Faculty of Nursing.