For Admission To Para Medical Courses [ For The Academic Session Starting From 1 st September, 2015 ]

Transcription

1 14-C, Beliaghata Main Road, Kolkata Website: admin@smfwb.in Fax No : For Admission To Para Medical Courses [ For The Academic Session Starting From 1 st September, 2015 ] Last date for submission of Application Form : (upto 5 P.M) PRICE : Rs. 400 /-

2 [1] Introduction State Medical Faculty of West Bengal ( hereinafter referred to as The Faculty ) is an autonomous body constituted by the Government of West Bengal in terms of the provisions of the statutes of the Faculty in this respect. The Faculty is empowered with the authority to conduct Examination of various Para Medical Courses as per course curriculum approved by the State Government as also to award Diploma / Certificate to the successful candidates of the approved courses. The Faculty holds the status of an Examining Authority in respect of the approved courses. The courses being offered by the State Medical Faculty of West Bengal are approved courses of the State Government and the Diplomas / Certificates being awarded by the Faculty are recognised by various States as well as Central authorities for the purpose of employment. Location The office of the State Medical Faculty of West Bengal is located at 14-C, Beliaghata Main Road, Kolkata , (behind Alo Chhaya Cinema Hall Bus Stop) Courses and their Duration The Courses being offered by the Faculty with duration are as follows : Diploma in Medical Laboratory Technology [Pathology, Microbiology & Biochemistry] : DMLT [ Tech] : 2 years + 6 months (Six Months) compulsory post examination training. Diploma in Radiography [ Diagnostic ] : DRD [ Tech ] : 2 years + 6 months (Six Months) compulsory post examination training. Diploma in Physiotherapy : DPT : 2 years + 6 months (Six Months) compulsory post examination training. Diploma in Radiotherapeutic Technology : DRT [ Tech ] : 2 years + 6 months (Six Months) compulsory post examination training. Diploma in Optometry with Ophthalmic Technique : D.OPT : 2 years + 6 months (Six Months) compulsory post examination training. Diploma in Neuro Electro Physiology: DNEP: 2 years + 6 months (Six Months) compulsory post examination training. Diploma in Perfusion Technology: DPFT : 2 years + 6 months (Six Months) compulsory post examination training. Diploma in Cath-Lab Technician : DCLT : 2 years + 6 months (Six Months) compulsory post examination training. Diploma in Dialysis Technique : Dialysis Technician : 2 years + 6 months (Six Months) compulsory post examination training. Diploma in Critical Care Technology : DCCT : 2 years + 6 months (Six Months) compulsory post examination training. Diploma In Operation Theatre Technology : DOTT : 2 years + 6 months (Six Months) compulsory post examination training. Diploma In Electrocardiographic Technique : ECG Technician : 2 years + 6 months (Six Months) compulsory post examination training.

3 [2] Commencement of the Courses The courses will commence from 1 st September 2015 at the following Institutes :- 1) Institute of Post Graduate Medical Education & Research, 244, AJC Bose Road, Kolkata ) Medical College, 88 College Street, Kolkata ) N.R.S.Medical College, 138 AJC Bose Road, Kolkata ) R.G.Kar Medical College, 1, Khudiram Bose Sarani, Kolkata ) Calcutta National Medical College, 32, Gorachand Road, Kolkata ) Bankura Sammilani Medical College, P.O Kenduadihi, Bankura ) Burdwan Medical College, P.O : Rajbari, Baburbag, Burdwan ) North Bengal Medical College, P.O Sushruta Nagar, Darjeeling ) Midnapore Medical College, Paschim Medinipur ] Bangur Institute of Neuro Sciences, 52/1A, Sambhu Nath Pandit Street, Kolkata ] Regional Institute of Ophthalmology, 88 College Street, Kolkata ] College Of Medicine & J.N.M Hospital, P.O: Kalyani, Distt: Nadia, PIN ] Malda Medical College & Hospital. English Bazar, Malda ] Murshidabad Medical College & Hospital. Gora Bazar, Berhampore, Murshidabad , 15] College of Medicine & Sagore Dutta Hospital. 578, B. T. Road, Kamarhati, Kolkata ] Chittaranjan National Cancer Institute, 37, Shyamaprasad Mukherjee Road, Kolkata ] Kolkata Port Trust Centenary Hospital, 1, Diamond Harbour Road, Kolkata ] ESI Hospital, Manicktala, 54, Bagmari Road, Kolkata ] ESI Hospital, Asansol, Kanyapur, [ Sen Raleigh Road ] Burdwan ] Susrut Eye Foundation, HB-36-A/1, Sector-III, Salt Lake, Kolkata ] Susrut Eye Foundation & Research Centre. 25/1, Kalikapur Road, Berhampore, Murshidabad ] Vivekananda Mission Asram, Viveknagar, Chaitanyapur, Haldia, Purba Medinipur ] Rabindranath Tagore International Institute of Cardiac Sciences,124, Mukundapur, E M Bye Pass, Kolkata ] U S Institute of Medical Technology, Education & Research, 594, Jessore Road, Nagerbazer, Kolkata ) Sevayatan School of Medical Technology, Ratanpur II, Singur, Dist. Hooghly ) Sonoscan Educational Institute, B G Road, Makdumpur, Malda ) Islamia Hospital Institute of Para Medical Studies, 73, C R Avenue, Kolkata ) Vivekananda Institute of Medical Science, Ramkrishna Mission Seva Pratisthan, 99, Sarat Bose Road, Kolkata ) Saroj Gupta Cancer Centre & Research Institute ( Formerly known as Cancer Centre Welfare Home & Research Institute ) M G Road, Thakurpukur, Kolkata ] Anandaloke Medical Centre Pvt Ltd, 2 nd Mile, Sevoke Road, PO. Siliguri ] Desun Hospital & Heart Institute, 720, Anandapur, Desun More, Kolkata ] Institute of Child Health, 11, Dr. Biresh Guha Street, Kolkata ] Apollo Gleneagles Hospitals, 58, Canal Circular Road, Kolkata ] Ashadeep Nursing Home & Diagnostic Centre PO & PS : Raghunathganj Dist. : Murshidabad 35] Institute of Neuroscience. 185/1, AJC Bose Road, Kolkata ] Institute of Radiology & Medical Imaging, C/o Institute of Neurosciences 185/1, AJC Bose Road Kolkata ] Medica Superspecialty Hospital. 127, Mukundapur, EM Bypass. Kolkata ] Burdwan Scan Centre Pvt Ltd. 7, R B Ghosh Road, Khoshbagan, Burdwan ] Peerless Hospitex Hospital & Research Centre. 360, Panchasayar, Kolkata ] The Calcutta Medical Research Institute, 7/2, Diamond Harbour Road, Kolkata ] Eye Care & Research Centre, Biplabi Niketan, 12A, Dr. Biresh Guha Street, Kolkata ] GD Hospital & Diabetes Institute, 139A, Lenin Sarani, Kolkata ] Haldia Institute of Health Sciences, ICARE Complex, PO. Hatiberia, Haldia, Dist. Purba Medinipur Note : Number of Affiliated Institutions vis-à-vis courses may be increased / decreased or omitted, which will be informed on the day of counseling.

4 [3] Rules governing the courses Eligibility for admission : 1. Any person seeking admission to any one of the courses must fulfill the following conditions: [a] That he/she has passed the Higher Secondary (10+2) or equivalent Examination recognized by any Indian University or a duly constituted Board with pass marks in Physics, Chemistry and Biology individually. [b] That he/she has attained the age of 17 years as on 1 st September, [c] That he/she has to furnish at the time of submission of application form, a certificate of Physical fitness from a registered medical practitioner and two references from persons other than relatives testifying to satisfactory general character. Procedure for submission of application (i) (ii) (iii) (iv) [v] [vi) Eligible candidates are to submit the Application Form for Admission to Para- Medical Course annexed to this Prospectus, duly filled-in neatly & correctly and countersigned by any Gazetted Officer affixing his Seal thereon by (upto 5 P.M). The filled-in Application Form for Admission to Para-Medical Course is to be sent to the Secretary, State Medical Faculty of West Bengal, 14-C, Beliaghata Main Road, Kolkata , by Registered Post / Courier superscribing the envelope with the words Application for Admission in Para Medical Course so as to reach him on or before the last date, (upto 5 P.M) or can be dropped in the Box kept at the office of the State Medical Faculty of West Bengal at the above address on working days. Attested copies of Mark Sheet for H.S / equivalent Exam, Admit Card for proof of age, SC/ST/OBC-A/OBC-B/PH certificate should be submitted alongwith the filled in application form. A candidate should not submit more than one application form. Xerox copy of application form will not be entertained. However, downloaded application form along with a bank draft of Rs. 400/- drawn in favour of State Medical Faculty of West Bengal payable at Kolkata may be accepted. Application forms received after the last date i.e (upto 5 P.M) will not be accepted irrespective of the date of dispatch. Incomplete application will be treated as cancelled. Mode of selection (i) (ii) Selection of candidates will be made in accordance with marks obtained in Higher Secondary (10+2) or equivalent examination in Physics, Chemistry and Biology. The Merit List of candidates will be displayed on at the above office of the State Medical Faculty of West Bengal as well as in the website of the Faculty ( (iii) After selection or publication of Merit List or during admission if it is found on scrutiny that an applicant furnished wrong information in the Application Form, his/her application for admission will be summarily rejected even though his/her name appears in the Merit List and also a seat allotted in the respective course. (iv) Counseling for admission in different Medical Colleges / Govt. Institutions / other Affiliated Institutions in respect of successful candidates from the Merit List in order of Merit, will be held at the Auditorium, Platinum Jubilee Hall, R. G. Kar Medical College. 1, Khudiram Bose Sarani, Kolkata , tentatively, on & from A.M onwards.

5 [4] [v] A candidate allotted a seat on a particular counseling date will have to deposit Rs.15000/- or Rs. *29,000/- [ *with rebate of Rs. 1000/- in case of one time payment towards 2 years course fees of Rs. 30,000/- at the time of Admission ] through Counseling by Demand Draft drawn in favour of State Medical Faculty of West Bengal, payable at Kolkata, failing which his/her seat will be cancelled. However, those candidates who will not be able to deposit the entire amount of course fees of Rs. 30,000/- at a time at the time of admission, will be allowed to deposit the second installment of course fees, that is, Rs. 15,000/- within Further, the second installment of course fees be deposited upto along with late fees of Rs. 1000/- only. [vi] The Candidate will have to appear personally for the selection of a Seat during counseling. If any candidate fails to appear personally his/ her authorized representative will have to produce valid authority letter and undertaking from that candidate. The authorized representative without valid undertaking and authority letter (as per proforma) shall not be allowed to participate in the counseling and the candidate shall forfeit the claim for a seat. (vii) The Candidates or Authorised representatives for personal appearance during counseling should bring along with them all Certificates including SC/ST/OBC- A/OBC-B/PH (with locomotive disorder only) & Mark Sheets in original for verification, failing which they shall not be allowed to participate in the allotment process in counseling and their claim will be forfeited. (viii) No separate intimation will be sent to any candidate by the State Medical Faculty for counseling and / or allotment of seat. (ix) Allotment of a seat of a particular Course & Institute for a candidate will be awarded according to merit list and as per availability of seats. [x] The fact that a candidate has appeared for allotment shall not entitle him/her for allotment / reallotment, as the same is subject to availability of seats and acceptance of the available seats by the candidates based on his/her rank in the merit list. (xi) Second Counseling will be held provided there is any vacant seat after first counseling at a fixed venue, date & time to be notified by the State Medical Faculty at the appropriate time. (xii) In the matter of allocation / admission of a candidate to a particular course/ Institute, the decision of the President, State Medical Faculty of West Bengal shall be the final & binding. Note : Dates are provisional and may be altered, to be notified in Faculty s website and Notice Board, as per discretion of the Authorities of the Faculty. Short Name of All Govt. Medical Colleges & Institutions MC, KOLKATA NRSMC, KOLKATA RGKMC, KOLKATA CNMC, KOLKATA IPGME&R, KOLKATA BMC, BURDWAN BSMC, BANKURA NBMC, DARJEELING BIN, KOLKATA MMC MIDNAPORE RIO, KOLKATA JNM HOSPITAL, KALYANI MMC, MALDA MMC, MURSHIDABAD SDMCH, KOLKATA - Medical College, Kolkata. - N.R.S.Medical College, Kolkata. - R.G.Kar Medical College, Kolkata. - Calcutta National Medical College, Kolkata. - Institute of Post Graduate Medical Education & Research, Kolkata. - Burdwan Medical College, Burdwan. - Bankura Sammilani Medical College, Bankura. - North Bengal Medical College, Darjeeling. - Bangur Institute of Neuro Sciences, Kolkata. - Midnapore Medical College, Paschim Medinipur. - Regional Institute of Ophthalmology, Kolkata - College Of Medicine & J.N.M Hospital, Kalyani. - Malda Medical College & Hospital, Malda - Murshidabad Medical College & Hospital, Murshidabad - College of Medicine & Sagore Dutta Hospital, Kolkata

6 [5] Seats of Para Medical Courses in different State Govt. Medical Colleges & Institutions for Admission in 2015 ALLOTMENT OF AVAILABLE SEATS IN DIFFERENT CATEGORIES MEDICAL COLLEGES COURSE SEATS GENERAL SC ST OBC - A OBC - B PH / INSTITUTIONS (2015) MC, KOLKATA DMLT DRD DPT DRT DPFT DCCT DCLT DOTT ECG DNEP TOTAL NRSMC, KOLKATA DMLT DRD DPT DRT DPFT DCCT DCLT DIALYSIS D.OPT DOTT ECG DNEP TOTAL RGKMC, KOLKATA DMLT DRD DPT DRT DPFT DCLT DCCT DIALYSIS DOTT ECG DNEP TOTAL CNMC, KOLKATA DMLT DRD DPT DCLT DCCT ECG D.OPT DOTT TOTAL IPGME&R, KOLKATA DMLT DRD DIALYSIS DPFT DCLT DCCT DRT ECG TOTAL BMC, BURDWAN DMLT DRD DRT DCLT DNEP ECG TOTAL BSMC, BANKURA DMLT DRD DRT DPT DIALYSIS DCCT DOTT ECG TOTAL NBMC, DARJEELING DMLT DRD DPT DRT DIALYSIS DCCT D.OPT DOTT ECG TOTAL BIN, KOLKATA DMLT DRD DNEP DCCT TOTAL

7 [6] Seats of Para Medical Courses in different State Govt. Medical Colleges & Institutions for Admission in 2015 ALLOTMENT OF AVAILABLE SEATS IN DIFFERENT CATEGORIES MEDICAL COLLEGES COURSE SEATS GENERAL SC ST OBC - A OBC - B PH / INSTITUTIONS (2015) MMC, MIDNAPORE DMLT DRD D.OPT DCCT DOTT ECG DIALYSIS TOTAL RIO, KOLKATA D.OPT TOTAL JNM HOSPITAL, DMLT KALYANI TOTAL MMC, DMLT MALDA DRD DCCT ECG TOTAL MMC, DMLT MURSHIDABA DRD DCCT DOTT ECG TOTAL SDMC, DMLT KAMARHATI, DRD KOLKATA DPT DOPT DOTT ECG TOTAL Total Seats of Para Medical Courses in different Affiliated Institutes in 2014 ALLOTMENT OF AVAILABLE SEATS FOR AFFILIATED INSTITUTES COURSE SEATS ANANDALOKE MEDICAL DMLT 06 CENTRE PVT LTD, SILIGURI DCCT 15 DIALYSIS 06 DRD 03 DOTT 04 TOTAL 34 APOLLO GLENEAGLES HOSPITALS, KOLKATA. DMLT 05 DRD 06 DCLT 03 DIALYSIS 06 DPFT 02 DCCT 04 DRT 02 DOTT 04 TOTAL 32 ASHADEEP NURSING HOME & DIAGNOSTIC CENTRE, DMLT 06 RAGHUNATHGANJ, MURSHIDABAD DRD 03 TOTAL 09 BURDWAN SCAN CENTRE, BURDWAN DMLT 03 DRD 04 TOTAL 07 CHITTARANJAN NATIONAL CANCER INSTITUTE, KOLKATA DRD 06 DRT 04 TOTAL 10 CALCUTTA MEDICAL RESEARCH INSTITUTE, KOLKATA DMLT 12 TOTAL 12 DESUN HOSPITAL & HEART DMLT 10 INSTITUTE, DESUN MORE, KOLKATA DCCT 08 TOTAL 18 ESI HOSPITAL, MANICKTALA, KOLKATA DMLT 20 DIALYSIS 08 TOTAL 28 ESI HOSPITAL, ASANSOL DMLT 10 DRD 05 TOTAL 15

8 [7] Seats of Para Medical Courses in different Affiliated Institutes in 2014 ALLOTMENT OF AVAILABLE SEATS FOR AFFILIATED INSTITUTES COURSE SEATS EYE CARE & RESEARCH CENTRE, KOLKATA D.OPT 05 TOTAL 05 GD HOSPITAL & DIABETES INSTITUTE, KOLKATA DMLT 05 DRD 05 TOTAL 10 HALDIA INSTITUTE OF HEALTH SCIENCES, PURBA MEDINIPUR DRD 04 DOTT 04 TOTAL 08 INSTITUTE OF CHILD HEALTH, DMLT 06 KOLKATA TOTAL 06 INSTITUTE OF NEUROSCIENCE, KOLKATA DOTT 04 DNEP 04 TOTAL 08 INSTITUTE OF RADIOLOGY & DRD 06 MEDICAL IMAGING, KOLKATA TOTAL 06 ISLAMIA HOSPITAL DMLT 12 INSTITUTE OF PARA MEDICAL DIALYSIS 04 STUDIES, CR AVENUE, KOLKATA TOTAL 16 KOLKATA PORT TRUST CENTENARY HOSPITAL, KOLKATA DMLT 10 TOTAL 10 MEDICA SUPERSPECIALITY HOSPITAL, KOLKATA DMLT 12 DPFT 04 DCLT 06 DCCT 04 DIALYSIS 10 TOTAL 36 PEERLESS HOSPITEX HOSPITAL & RESEARCH DMLT 10 CENTRE LTD, KOLKATA DRD 10 TOTAL 20 RABINDRANATH TAGORE DMLT 10 INTERNATIONAL INSTITUTE OF DRD 06 CARDIAC SCIENCES. MUKUNDAPUR DCLT 04 KOLKATA. DPFT 05 D.OPT 05 DIALYSIS 10 DOTT 04 TOTAL 44 SAROJ GUPTA CANCER CENTRE DMLT 10 & RESEARCH INSTITUTE, DRD 04 THAKURPUKUR, KOLKATA DRT 06 TOTAL 20 SEVAYATAN SCHOOL OF MEDICAL DMLT 12 TECHNOLOGY, SINGUR TOTAL 12 SONOSCAN EDUCATIONAL DMLT 10 INSTITUTE, MALDA DIALYSIS 05 TOTAL 15 SUSRUT EYE FOUNDATION, SALTLAKE D.OPT 15 KOLKATA TOTAL 15 SUSRUT EYE FOUNDATION, D.OPT 10 BAHARAMPUR, MURSHIDABAD TOTAL 10 U S INSTITUTE OF MEDICAL DMLT 20 TECHNOLOGY, NAGERBAZAR, KOLKATA TOTAL 20 VIVEKANANDA INSTITUTE OF DMLT 20 MEDICAL SCIENCE, DRD 08 RAMKRISHNA MISSION SEVA PRATISTHAN, KOLKATA TOTAL 28 VIVEKANANDA MISSION ASRAM, CHAITANYAPUR, HALDIA D.OPT 10 TOTAL 10 GRAND TOTAL 464 As inspection to the above Affiliated Institutions is yet to be completed, Increase/Decrease in number of the seats in the above Affiliated Institutes will be confirmed subsequently through website/notice Board of the Faculty A few more Institutes have applied for affiliation for conduction of different Para Medical courses under the aegis of the State Medical Faculty of West Bengal from the Academic Session Their intake of students as well as Courses will be informed in due course through Website / Notice Board of the Faculty.

9 [8] Reservation of seats Seats for SC/ST/OBC-A/OBC-B/PH (with locomotive disorder only)* will be kept reserved as per Statutory provisions. The Disability Certificate should be produced from the duly constituted authorized Medical Board. Fees payable by the students For Govt. Institutions The selected candidate is to pay the total Course fee of Rs. 30,000/- for any of the Diploma Courses for admission in the State Govt. Medical Colleges/Institutes. Henceforth, the course fees amounting to Rs. 30,000/- for the entire period of the course, that is, both first and second year course fees, may be deposited by the candidate at the time of admission at a time and in that case, they will be allowed a rebate of Rs. 1000/-. However, those candidates who will not be able to deposit the entire amount of course fees of Rs. 30,000/- at a time at the time of admission, will be allowed to deposit the second installment of course fees, that is, Rs. 15,000/- within Further, the second installment of course fees be deposited upto along with late fees of Rs. 1000/- only. The first installment of Rs. 15,000/- should be deposited at the time of admission through Counseling by Demand Draft drawn in favour of State Medical Faculty of West Bengal, payable at Kolkata. The above course fees includes student s Registration fees (Rs.500/-) and Examination fees (Rs.400/-) each for Preliminary & Final examination (For one time). The candidates will have to bear the entire expenses for undergoing the courses and the Faculty will not award any stipend for this purpose. However, stipend of Rs.500/- per month is admissible to all the students undergoing post examination training limited to 6 months for all the Courses soon after passing the examination. For Affiliated Institutions For Fees payable by the students of Affiliated Institutions, the website of the State Medical Faculty of West Bengal may be visited. Mode of Fees payable by the students of all the Institutions The above charges are payable in the following manner: Rs /- (Rupees Fifteen Thousand) or Rs. *29,000/- [Rupees Twenty Nine Thousand] (*with rebate of Rs. 1000/- in case of one time payment towards 2 years course fees of Rs. 30,000/- at the time of Admission) through Counseling at the Counseling Hall. However, those candidates who will not be able to deposit the entire amount of course fees of Rs. 30,000/- at a time at the time of admission, will be allowed to deposit the second installment of course fees, that is, Rs. 15,000/- within Further, the second installment of course fees be deposited upto along with late fees of Rs. 1000/- only. Registration, Exam Fees & other fees are payable separately by the students admitted in CNCI, ESI, KPT and Non Govt. Institutions separately at their respective Institutions after admission. In case of discontinuity of studies on valid grounds by a student of any of the Affiliated Institutes, refund of course fee will be made after deduction of Rs. 3000/- provided an application is made just within a month from the date of admission. *Locomotive disability involving upper limb should not be considered. The Locomotive disability involving lower limb is permissible but it should be within the following guidelines: a) If it involves only one lower limb it should have a Minimum of 40% and should not exceed 60% b) If it is involved both the lower limbs the total disability should not exceed 60% with a Minimum of 40%

10 [9] Examination of the courses The Examination of the respective courses will be conducted in terms of the provisions contained in this respect in the respective course curriculum/regulations approved by the State Government. Internship / Post Examination Training 6 months internship with duration of 600 hrs for all passed out students of Diploma courses is compulsory and the same should be completed just after passing the Final Examination. Eligibility for appearing in any Examination 1. Internal Assessment marks for all Para Medical Courses have been introduced from the academic session 2013, 20% of allotted marks in Theory and 10% of allotted marks in Oral and Practical in each paper of Diploma courses would be assigned for internal assessment marks. Pass marks in Internal assessment is 50% in each paper rounded off to the nearest five. A candidate should not be allowed to sit for examination without pass marks in Internal Assessment. 2. A candidate has to secure at least 75% attendance [separately in theoretical and Practical] for appearing at any of the Examinations of any course. No relaxation, whatsoever, will be permissible to this rule under any ground including indisposition etc. Fees payable by a student for appearing at the Examination with shortage of attendance Any student, appearing with shortage of attendance at any Examination, will have to pay the following fees: [a] For percentage between 70 and 74 : Rs [b] For percentage below 70 but more than 60 : Rs No candidate will be allowed to make good of his/her shortfall in attendance below 60% without being re-admitted in the course in one of the subsequent sessions. However, the Faculty reserves the right of admission of any such discontinued students in the subsequent academic session/s due to nonavailability of seat. Cancellation of admission The State Medical Faculty shall have the right of cancellation of admission and/or studentship of any student during the session if he/she is found guilty of any of the following charges: a] Suppression of information b] Supply of false information c] General misconduct unbecoming of a student d] Adoption of unfair means at the examination and e] General indiscipline. General guideline concerning the courses [i] The State Medical Faculty of West Bengal, with the prior approval of the State Government, shall reserve the right to alter / modify / amend any or all the rules concerning conduction of the above courses in any Institution. [ii] No Hostel facilities will be available Annexure I - Proforma of authorisation letter Annexure II - Application Form for admission to Para-medical course.

11 ANNEXURE I NOT TO BE SUBMITTED WITH APPLICATION FORM Proforma of Authorisation Letter (To be submitted during counseling only in absence of candidate) I Sri /Smt. Son/Daughter of residing at holding form No. do hereby authorise Sri/Smt. my (relation to be stated) to appear before the counseling for admission in Para Medical Courses in different Teaching Institutions in West Bengal under the aegis of the State Medical Faculty of West Bengal on production of this authorised letter for allotment of a seat in my favour according to his/her decision during counseling being conducted by the State Medical Faculty of West Bengal. I am also sending the following certificates and mark sheet in original for verification by the authorities concerned at the time of counseling:- a) Admit Card / Certificate of Madhyamik Examination b) Marks Sheet of H.S. (10+2) or equivalent Examination. c) Caste certificate in case of SC/ST d) Valid disability certificate in case of PH candidates ( with locomotive disorder only )* Signature of Authorised Person Signature of Applicant in full Attested Signature of Applicant in full * Locomotive disabled involving upper limb should not be considered. The Locomotive disabled involving lower limb is permissible but it should be within the following guidelines: a) If it involves only one lower limb it should have a Minimum of 40% and should not exceed 60% b) If it is involved both the lower limbs the total disability should not exceed 60% with a Minimum of 40%

12 ANNEXURE II State Medical Faculty of West Bengal Application Form for Admission to Para-Medical Course Form No. Category (For office use only) GN/SC/ST/OBC(A)/OBC(B)/PH To be filled in Block Letters Affix Stamp Size Photograph 1. Name of the applicant in full : First Name Middle Name Surname 2. Category : General / SC / ST / OBC(A) / OBC(B) / PH (with locomotive disorder only) [ Tick ( ) whichever is applicable ] 3. Father s Name : First Name Middle Name Surname 4. Date of birth : D D M M Y Y 5. Age as on : Years Months Days. 6. Present Address : 7. Telephone No. (Residence/Mobile) : 8. Qualifying Examination passed : 9. Name of the Board / Council : 10. Marks obtained in Higher Secondary (10+2) or equivalent recognised Examination in: Full Marks Pass Marks Marks Obtained Physics (1) Chemistry (2) Biology (3) Total of (1+2+3) Signature of the applicant in full Signature of Gazetted Officer with office Seal on verification of Photograph, Signature of the candidate and Sl.No 2,4,& 10. Note: 1) Any candidate furnishing wrong / false/ incomplete information in this form, his / her application will be treated as cancelled and he / she shall automatically lose the chance of counseling for the Session ) Xerox copies of the certificates against Sl.. No. 2, 4 &.10 be submitted with the Application Form. Declaration I shall not continue any other course alongwith Para Medical Course, if admitted.. Signature of the Candidate

13 State Medical Faculty of West Bengal ADMISSION TO PARA MEDICAL COURSES IMPORTANT DATES ISSUE OF PROSPECTUS ALONG WITH APPLICATION FORM. LAST DATE FOR ISSUE OF PROSPECTUS LAST DATE FOR SUBMISSION OF FILLED IN APPLICATION FORM. DATE OF PUBLICATION OF MERIT LIST. DATE OF COUNSELING. From to upto 5 P.M at SMFWB office at SMFWB office & at website Tentatively, & TIME OF COUNSELING A.M onwards VENUE OF COUNSELING. AUDITORIUM PLATINUM JUBILEE HALL R. G. KAR MEDICAL COLLEGE 1, KHUDIRAM BOSE SARANI KOLKATA