ONLINE APPLICATION FOR SUPERSPECIALITY COURSES AT S.C.B.MEDICAL COLLEGE, CUTTACK, FOR THE YEAR 2016-17 INTRODUCTION FOR ONLINE REGISTRATION FOR D.M / M.Ch The Online Registration process for the Application for D.M / M.Ch Courses in Odisha for the Academic Year 2016-17 will held from 10-06-2016 (10 a.m) to 17-06-2016 (till 5 p.m). Candidates are advised to be well prepared in advance with all the documents ready before going for online registration and filling the application form. After successful online registration and filling the application form online, Candidates are advised to take a print out of the copy of the online Application form. Besides the Candidate has to Sign the printed Application form (in the space provided for Signature) and to bring the Completed Application with one set of Xerox copies of desired documents along with the Original documents for Verification. The candidates may keep one copy of the Printed application form for their future reference. APPLICATION FORM FOR SELECTION IN TO D.M / M.Ch COURSES IN ODISHA 2016-17 Please ensure that, you have the following documents ready at hand before you fill the online application form : 1) Printed Manual of Guidelines / Instruction Manual/ Prospectus 2) H.S.C/ Matriculation Certificate 3) M.B.B.S. Degree Certificate 4) M.D/ M.S or DNB Degree /Equivalent Degree (or) 5) Tentative PG completion certificate from the Dean & Principal. 6) Medical Registration of MBBS & M.S / M.D Certificate 7) Resident Certificate 8) Conduct Certificate 9) Appendix I(for candidates under employment other than State Govt.) 10) Appendix II(for both direct & in-service candidates) 11) Appendix III(for both direct & in-service candidates) 12) Appendix IV (for in-service candidates) 13) Appendix V (for candidates under employment other than State Govt.) 14) Appendix VI (for both direct & in-service candidates) 15) Intimation letter from employer (in case of in-service candidates) 16) Bank draft of Rs. 2500/- (Rupees two thousand five hundred only, issued by State Bank of India) to be drawn in favor of ENTRANCE EXAMINATION FEES Payable at State Bank of India, HOD Branch, Bhubaneswar (Code No. 10249). 17) Scan copy of the Passport size photograph and your Signature (only.jpg /.jpeg formats)
Please read the following instructions before filling the form online : (The sample screenshot is given as a material of reference in which there is no resemblance of the year mentioned and necessary changes are made for each year as per the change in prospectus). Part-I (Preliminary Registration ) :- The candidate has to register himself / herself first to become eligible for online filling up the Application Forms. During the Preliminary Registration process, Candidate has to register by giving his / her valid e- mail address as log in id and should enter his / her own password which should not be disclosed to others for security reasons. In general the password should be a combination of alpha, numeric, a special character (means asd#123) and should be minimum 6 characters and maximum 8 characters long. After successful preliminary registration, a system generated e-mail will be sent to the candidate s registered e-mail address. Besides, the password will be also sent to the given Mobile number for Confirmation (Mobile numbers having DND facility will be deprived of getting the service). After completing the Preliminary Registration, the Candidate may go for the filling up the Online Application Form in 2 parts. Else, they can log out and after getting the information ready at hand they can Log in again and Fill the Online Application Form in 2 parts details of which are described as under.
Part-II (Basic Information) :- a) First of all the applicant has to choose which course he / she is applying (D.M / M.Ch) b) Candidate Name There is no need to fill this Parameter again, as the information is already entered at the time of Preliminary Registration and available (showing) in the space provided for it. c) Father s Name Enter your Father s Name clearly as mentioned in 10 th / Board certificate d) There is no need to enter the e-mail here, as the e-mail (login ID) will automatically retrieved and shown here. e) Please enter your land line (telephone Number) with STD code in the first Box and Telephone number in Second Box (if you have one) else, leave this section. f) Date of Birth Please select from the given calendar and automatically by clicking the mouse inside the text box, and fill the date of Birth. If the Calender is not sees, then fill your date of Birth in DD/MM/YYYY Format. g) Please fill the date of birth in the figure in the below mentioned box which is meant for words. Your date of birth should be as per your Matriculation / 10 th Certificate h) Sex Select the option from the list i) Marital Status Please select the option from the drop down list
j) Select the Category you belongs to. If you belong to more than one category like SC with GCH and PH, then Please select and Press the Ctrl key from the key board and select the Categories from the drop down list which will be highlighted in Ink color. If you want to remove the selection, then double click on the Category, it will be deselected again. k) Domicile / Resident / Nativity Status Please select either you are a Resident of Odisha or other state. l) Then Choose your Scan copy of Photo and Signature (only.jpg and.jpeg formats) and after choosing, you can see your file name will be mentioned in the place No file Choosen. m) Details of Bank Draft (Application Fee) Please fill the details of Bank Draft as Application Fee to take part in the Counseling process. Candidate should purchase a Bank draft of Rs. 2500/- (Rupees two thousand five hundred only, issued by State Bank of India) to be drawn in favor of ENTRANCE EXAMINATION FEES Payable at State Bank of India, HOD Branch, Bhubaneswar (Code No. 10249) and the details of Draft No, Draft Date, Bank Name and Place of issue should to be mentioned in the place given in the online application. n) Permanent Address / Address for Correspondence Please fill up your permanent address and select the Box (click the chk box) if your correspondence address is same as your permanent address. otherwise please fill up the information about your correspondence address if it is different from your permanent address.
o) Mobile No- Please ensure that your mobile number is not covered under DND option, otherwise, automatically system generated SMSs can not be delivered to your mobile no. In case you have the Mobile no with DND facility, then not to be worried. You will be communicated over your e-mail address. p) Address of father / husband / guardian (if father / husband is dead) Please fill up your address of father / husband / guardian. And please select the check box (tick mark) if your address of father / husband / guardian is same as your correspondence / permanent address. 1. Under the Section EDUCATION DETAILS, Please enter your MBBS and Post Graduation (MD / MS) details like Name of the Institute from which passed, Name of the University, Year of passing and no of attempts made to pass the degree etc in the space given in the application. If you are selecting your Post Graduation (MD / MS), then please fill the Specialization like if MD then Pediatrics / Medicine etc in the next Text Box before filling the Name of the Institute. 2. Medical Council Registration No- Please enter your valid State / Central Medical Council Registration No in the space given. q) After completing the information, then please click on the button CLICK HERE TO SAVE & FILL SERVICE PARTICULARS.
Part-III (Education & Service Particulars) :- As per Govt. of Odisha, In-service Candidate is one, who, at the time of application, is in the employment of Govt. of Odisha / Govt. of Odisha undertaking and must have completed 3 years of service by 31.7.2015 (excluding at a stretch leave of 30 days or more). The maternity leave will not be counted for this purpose. The employment includes all category of employment under Govt. of Odisha / Govt. of Odisha undertaking like Adhoc/ Temporary/ Contractual and / or Regular appointments. So, if your candidature comes under this category, then please select the option I am an in-service Candidate and the following information are applicable for me otherwise you can choose the alternate option (applicable for Fresher / Direct Candidates) 1. Category Applied For :- Please select the option whether you belong to Direct or inservice Category as per the instructions given above. If you come under Fresher / Direct category, then the information that are required for in-service Candidates will not be displayed to you. It will be directed to another page where you can take the print out of the Online Application Form. 2. If you come under In-service category, then please fill up the following information about your service issued by the CDMO / Competent authority a) Service Particulars in Odisha (up to 31.7.2016 ) The candidate has to fill the information like Designation, the Name of the Medical / Hospital under place of posting, Date of Joining, Present
Status (whether Continuing or Relieved from that place) and date of Relief in case already Relieved. And after filling the details information, automatically, the duration of Service (in no of days ) will be calculated and will be shown in the next column. If the candidate is having more than one information to enter, then they can click the option Add New. b) Leave Particulars (Till the date of Application):- In the above same manner the candidate can fill up their leave particulars. Candidates are advised to fill up their leaves only if they have availed their leaves at a stretch 30 days or more excluding Maternity leave. Maternity leave up to 6 months will not be calculated under the head Leave Particulars, but more than 6 months will be calculated. c) Total Period of Service - After filling up the both information of Service and Leave Particulars, automatically the Total Period of Service will be calculated by the system and in the space, this will be displayed (in no of days). d) After filling up the Information about your Education and Service particulars, you can Click on SAVE & CONTINUE else, you can cancel the information and repeat the procedure again. e) If everything is correct, then you can take the print out of the submitted application in the next page. i. If any thing wrong data that you have entered during filling up the information, then nothing to be worried. You can log out and Log In again and Edit the Information that you have submitted and after editing the information, you can again take the latest print out of your application. The facility will be available only up to the last date of Registration that is 5 p.m of 03-06-2015. ii. If you have not completed your application online in all respect before the last date of Registration that is 5 p.m of 17-06-2016, then your incomplete application will be automatically rejected.
iii. But you can take the print out of the online application till the last day of the document verification that is till 3.00 p.m of 23-06-2016. iv. After taking the printouts of application form, bring all of the documents as mentioned in your application checklist for verification to the mentioned venue during the verification period as per your convenient. v. In case you can t come personally for verification, you can send somebody with an authorization letter along with the original documents, Valid ID Proof and one set xerox copy of the same to be submitted to the Convener during verification process.
vi. At any point of time, before verification, if some typographical error is found out in the Application form, please bring the discrepancy to the kind notice of the verification team to be corrected by the team at the time of verification. vii. Facing any technical difficulties in the online registration process, please call on 09776040400 / 9776640400 (only for Technical Queries DURING OFFICE HOURS 10 a.m to 5 p.m). Technical Team