BATCH POST GRADUATE ADMISSION DETAILS BANGALORE MEDICAL COLLEGE & RESEARCH INSTITUTE, BANGALORE DOCUMENTS REQUIRED

Transcription

1 BATCH POST GRADUATE ADMISSION DETAILS BANGALORE MEDICAL COLLEGE & RESEARCH INSTITUTE, BANGALORE DOCUMENTS REQUIRED 1. Entrance Admission Ticket / Allotment Order 2. MBBS Marks Card (First year to Final year) 3. House Surgeon Certificate/ Provisional Certificate 4. Registration Certificate of State Medical Council 5. UG Degree Certificate 6. Attempt Certificate 7. SSLC Marks Card / Birth Certificate 8. Eligibility Certificate issued by RGUHS (Other state candidates) 9. Relief Order (In service Candidates) 10. Penalty Bond Rs.200/- bond paper + Service bond Rs.300/- bond paper 11. Migration Certificate 12. Transfer Certificate 13. Domicile Certificate 14. Caste Certificate 15. Probationary Declaration letter (In service Candidates) 16. Photograph 17.Aadhar card Xerox

2 -1- No.BMCRI/PGs/ / QUOTA OFFICE NOTE Sub: Admission of candidate to Post Graduate course for the academic year Candidate : Dr. has submitted the following certificates 1. Entrance Admission Ticket / Allotment Order 2. MBBS Marks Card (First year to Final year) 3. House Surgeon Certificate/ Provisional Certificate 4. Registration Certificate of State Medical Council 5. Degree Certificate/Provisional 6. Attempt Certificate 7. SSLC Marks Card / Birth Certificate 8. Eligibility Certificate issued by RGUHS 9. Relief Order 10. Rs.200/- bond paper + Rs.300/- bond paper 11. Migration Certificate 12. Transfer Certificate 13. Domicile Certificate 14. Caste Certificate 15. Probationary Declaration letter (In service Candidates) 16. Photograph 17.Aadhar card Xerox 2. Order are solicited to accept the above certificates and admit the candidate provisionally at his/her own risk, subject to admission approval by the Rajiv-Gandhi University of Health Sciences. 3. Academy Superintendent 4. Assistant Administrative Officer 5. Chief administrative Officer 6. Director cum Dean

3 -2- PROFORMA SHOWING THE PARTICULARS OF THE POST GRADUATE STUDENT 1. Name of the Student : 2. Father s Name : 3. Mother Name : 4. Religion & Caste (Subcaste) : 5. Date of Birth : 6. Permanent Address : 7. Address in Bangalore : 8. Landline/Mobile Phone No : 9. ID: 10. Aadhar card No: 11. Bank Account No: 12. Medical Registration No: 13. Marks Obtained in Entrance Exam: 14. Hyderabad Karnataka Quota: Yes or No 15. PH Quota: Yes or No 16. Last Institution Studied : 17. Date of joining the PG course : 18. Course to which selected : 19. AIQ/ SEQ Candidate Signature of the Candidate

4 -3- DECLARATION I, Dr. A.T.No. is selected for admission to course and allotted to Bangalore Medical College & Research Institute hereby declare as under : 1. At Present I am not perusing Post Graduate Medical Degree /Diploma in any college in India. 2. In case if I am a diploma holder I will claim MD / MS in the same Subject only. I am aware that in case any of the above information is found to be false, I shall forfeit the seat allotted to me and render myself liable for civil and criminal action as per selection rules. Place : Date : Signature of the candidate NOTE : In case of candidates who have passed post graduate Diploma course and now selected for Degree courses in the specialty, item No.2 of the above declaration to be scored.

5 -4- DECLARATION I Dr., Subject hereby declare that, I pay a penalty of Rs. Five Lakhs for degree & Rs. Two and Half Lakhs for diploma along with remaining course fee & stipend recived, If I surrendered / discontinued the course. Signature DECLARATION (Mandatory services by PG medical students after successful completion of course as per Government order no.akuka/79/rgu/2011/ I Dr. Subject hereby declare that after my successful completion of PG course ( Diploma / Degree), abide to do he/she should serve minimum period of Three years Government service if Government desires. Candidates who are availed 100% tution fee reimbursement from the Government should furnish an undertaking that he/she should serve the Government for a period of five years. If Government desires. Note: If I fail to obey the orders of serving at Government, I will pay the penalty of Rs. Fifty Lakhs for degree, Rs.Twenty five lakhs for diploma. Signature

6 -5- SERVICE OBLIGATION BOND DATED: / / I.Dr. S/D/W/o. aged about ( ) years, residing at being a candidate with admission ticket no have selected a medical seat for post graduation Degree/Diploma)of years course out of my own volition in (Subject) at Bangalore Medical College & Research Institute Bangalore(vide admission order dated ( ) do here by STATE AGREE AND UNDERTAKE AS HEREUNDER: 1.(a): I am aware of the intent and content of Rule 15 of the Karnataka Conduct of Entrance Test for selection and admission to Post Graduate Medical Degree and Diploma Courses Rules 2006 as amended up to date. (b): Rule 15(5) of the above Rules states that candidate selecting Government Colleges and Government seats in Private Colleges under concession fee for post graduate course shall furnish an Undertaking that he will serve the government for a minimum period of three years after completion of the course, if Government desires. (c) Rule15(6)of the above Rules states that candidate who avails 100 percent tuiton fee reimbursement from the Government shall furnish an Undertaking that he will serve the Government for a minimum period of five years if Government desires. (d): Rule 15(7) of the above Rules states that a Penalty of Rs. Fifty lakhs for Degree and Rs.Twenty five lakhs for Diploma in lumsaum shall be levied in case the candidate fails to serve the Government after completion of the course as per the Undertaking as per Rule 15(5) and Rule 15(6) of the above Rules. (e): I hereby unequivocally AGREE and UNDERTAKE to abide by the terms of the above Rules 15(5)(6) and (7) as applicable to me 2. I do hereby AGREE and UNDERTAKE that I will not lay any claim to provide me a post after completion of the above course befitting to my specialized Degree /Diploma and I will serve in any post shown to me by the Government without reserving any right in that regard. 3. I do hereby AGREE and UNDERTAKE that incase I come in the category of candidates who have completed MBBS course in any Medical College run by the Government of Karnataka and failed to serve in any Primary Health Centre or Primary Health Unit in the rural areas of Karnataka for the minimum period of one year after completion of the MBBS course, I am prepared to serve in the Government after the completion of my post graduation Degree/Diploma for a period of 4 (four) years (inclisive of that period of one year rural service ) If my candidture

7 -6- comes within the purview of Rule 15(5) OR for a period of 6(six) years inclusive of that period of one year rural service )if my candidature comes within the Rule 15(6) of the above Rules. 4. I do hereby AGREE and UNDERTAKE that in case I come in the category candidates who have completed MBBS Course in any Medical college run by the government and failed to serve in any Primary Health Centre or Primary Health Unit in the rural areas of Karnataka for the minimum period of one year after completion of that course, I am prepared to serve for a total period of four years (inclusive of that period of one year) if my candidature comes within the purview of Rule 15(5) OR,for a total period of six years if my candidature comes within the purview of Rule 15(6) of the above Rules as the case may be. 5. I do hereby Agree and UNDERTAKE that incase I had completed my MBBS course through Government seat and failed to so serve the Government in the rural areas of Karnataka and also if I fail if to serve the Government for a period of 3 years on completion of my post graduation Degree /Diploma (as the case may be ) as per Rule 15(5) of the above Rules, I would pay Rs.One lakh being the penalty for not serving in the rural area after completion of MBBS course with interest at 10% p.a by way of penalty and also Rs. Fifty lakhs if I fail to so serve in the Government on completion of my post graduation degree OR Rs.Twenty five lakhs for failure to so serve in the Government on completion of the post graduation Diploma as the case may be in lumpsum and on demand by the Government without any protest or delay. 6. I do hereby AGREE and UNDERTAKE that in the event of my leaving the post graduation course in the middle i.e before its completion,i will voluntarily reimburse the loss occasioned to the Government on account of the loss of one Government seat which otherwise would have accrued to the benefit of the Government but for my omission to complete the course,as assessed and demanded by the Government. Executed and signed in the presence of witnesses on this day of (add month here).2016 at (add place here) Signatures and Addresses of the Witneses. Signature of the Candidate 1. Name of the Candidate 2. Candidate Mobile No:+91 e.mail: State Registration No

8 -7- PENALATY BOND STAMP PAPER VALUE NOT LESS THAN Rs.200/- DATED: / / KNOW ALL MEN BY THESE PRESENTS THAT WE Dr. S/D/W/o. aged about ( ) years, and residing at (Hereinafter called the Obliger) and S/D/W/o. aged about ( ) years, and resident at (herein after called the surety) do hereby jointly and severally bind ourselves and our respective heirs, executors and administrators to pay to the Government of Karnataka (herein after called the Government ) on demand the sum of Rs.5,00,000/-(Rupees Five Lakhs only) in case of Degree and Rs.2,50,000/-(Rupees Two Lakh Fifty Thousand only) in case of Diploma and stipend as detailed herein below together with interest thereon from the date of demand at Government rates for the time being in force on Government loans, AND TOGETHER with all costs between attorney and client and all charges and expenses that shall or may have been incurred by the Government. WHEREAS the obliger has been granted a seat for post Graduate studies in ( ) At Bangalore Medical College & Research Institute, Bangalore NOW THE CONDITION OF ABOVE WRITTEN OBLIGATION THAT in the event of the obliger leaving the course by discontinuance or otherwise and thus failing to complete the course, the obliger and the surety shall forthwith pay to the Government on demand the said sum of Rs.5,00,000/-(Rupees Five Lakhs only) in case of Degree and Rs.2,50,000/-(Rupees Two Lakh Fifty Thousand only) in case of Diploma plus stipend drawn by the obliger from Government during the period of his/her Post Graduate study in ( ) Bangalore Medical College & Research Institute, Bangalore together with interest thereon from the date of demand at Government rates for the time being in force of Government loans. In addition to the prescribed fine, every candidate shall pay the remaining period course fee on his own to the Government/Private Colleges in the event of he/she leaving the course before its completion. PROVIDED always that the liability of the surety hereunder shall not be impaired of discharged by reason of time being granted or. By any forbearance act of omission of the Government of any person authorized by them (whether with or without the consent or knowledge of the surety) nor shall it be necessary for the Government to sue the obliger before suing the surety amounts due hereunder.

9 -8- THE BOND SHALL BE in all respects be governed by the Laws of India for the time being in force and the rights and liabilities hereunder shall where necessary be accordingly determined by the appropriate courts in India. SIGNED AND Dated this day of two thousand SIGNED AND delivered by the obliger above named Dr. in the presence of WITNESS WITH NAME 1. AND ADDRESS 2. SIGNED AND delivered by the surety above named in the presence of WITNESS WITH NAME 1. AND ADDRESS 2. Candidate Mobile No: State Registration No