Muthoot College of Nursing | Application Form

MGM MUTHOOT COLLEGE OF NURSING

College Road, Kozhencherry – 689641, Pathanamthitta District, Kerala
Phone: 91 468 2279158 E-mail: con.kzy@muthoothealthcare.com

Affiliated to Kerala University of Health Sciences, Thrissur
Approved by Indian Nursing Council & Kerala Nurses & Midwives Council, Thiruvananthapuram

COURSE: B.Sc. NURSING

Name of student (as in SSLC) *

Date of Birth *

SSLC to prove date of birth* (jpg,jpeg,png,pdf)

Upload Your Passport size Photo (150 x 200) * Size - 200kb(jpg,jpeg,png)

Upload Your Signature * Size - 20kb(jpg,jpeg,png)

Category *

Religion *

Cast *

Aadhaar No.*

Nativity(Nationality) *

Name of parent /Guardian *

Relationship *

Address with district & PIN *

Mobile *

E-mail id *

Are You Physically Handicapped?* * Yes No

Name of Qualifying Exam*

Plus two* (jpg,jpeg,png,pdf)

Percentage of Mark (Total)*

PCB (Physics+Chemistry+Biology)*

Biology (%)*

English (%)*

Maths*

Board*

Transaction id*

Declaration

I hereby declare that the details provided in the in the application are true to the best of my knowledge

MGM MUTHOOT COLLEGE OF NURSING

College Road, Kozhencherry – 689641, Pathanamthitta District, Kerala Phone: 91 468 2279158 E-mail: con.kzy@muthoothealthcare.com

COURSE: B.Sc. NURSING

Declaration

College Road, Kozhencherry – 689641, Pathanamthitta District, Kerala
Phone: 91 468 2279158 E-mail: con.kzy@muthoothealthcare.com