Amendment status not verified — confirm the current text below against the official source.
(b) Draft Prepared fiom(Bank) I submit herewith original certificates for verification and submit attested copies of the same certificates if registered elsewhere (MCI and other State) (i) Bii CertiticateA4atricnlate Certificate/SSC Exam certificate with date of birth. i MBBS Degree / Post Graduate Degree / Diploma / Post Doctoral Degree /any other i State Medical CounciVMedical Council Of India Registration certificate with MBBS Qualitication. (iv) O r i d Internship Completion C d ~ c a t e . (v) Other evidence in support of my having obtainedthe qualification which Ipossess. (vi) No Objection Certificate fiom State Medical Council where earlier registered. (viii Three recent passport size photographs with name and signature at the backside (viii) Bank Drafts Rs 1000/- (Rupees One Thousand Only) in favour of 'Nagaland Medical Council'. (a) In case of eesh registration. (i) Birth Certificate / Matriculate Certificate / SSC Exam Certificate with date of birth. 6) MBBS Degree / Post Degree /Diploma/ Post Doctoral Degree. (iii Original Internship Completion Certificate. (iv) Other evidence in support ofmy having obtainedthe qualification which1 possess. (v) Three recent passport size photographs withname and signature at the backside. Year of QmMication Name of the Boardl University Year of Qwhfication /completion of Internship Name of the School/ College/ Institution S1 No Name of the Boardl University Description of QuaMotion Name of the School College/ Institution Sl No. Description of QuaWication (vi) Bank Draft of Rs I000/- (Rupees One Thousand only) in favour of 'Nagaland Medical Council'. DECLARATION I solemnly affm and declare that the particulars furnished above by me are true to the best of my knowledge and belief and I undertake to abide by the code of conduct & Ethics ofNagaland and Indian Medical Council and by Rules ofNagaland Medical Coulcil. Date. ....................... Signature of the Applicant. (For office use only) Received the above documents in original) ....................... Signature of registered person Name ................................................................. Date ................................................................... FORM 2 REGISTRATION CERTIFICATE CERTIFICATE OF REGISTRATION This is to certify that.