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M.Sc/PG Diploma in Oncology Nursing Registration Form
Applicant Information
First Name *
Last Name *
Gender:
Male
Female
Date of Birth * (MM/DD/YYYY)
Address:
Street:
City:
State:
ZIP Code:
Contact Information:
Phone Number:
Email Address:
BPL Certificate Number *
Educational Qualifications
Current Qualification *
Select qualification
BSc Nursing
Diploma in Nursing
Other (please specify)
Name of Nursing College: *
Address:
Year of Passing *
Work Experience
Current Employer: *
Designation: *
Years of Experience: *
Documents Upload
BPL Certificate
Nursing Registration Certificate
Mark Sheets and Certificates of qualifying exams
ID Proof (Aadhaar/PAN/Passport)
Declaration *
I certify that the information provided is accurate and true. I understand that providing false information may lead to rejection of my application.
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