Amendment status not verified — confirm the current text below against the official source.
Nagaland Nursing Council RcjjisttatOfl Certificate No & Date Q. Present occupation 41 The Nagaland Gazette, Part-V 29, June, 2019 I submit herewith original wtiflcates for verification and gubmit attested copies of the same ceilificates. (a) Two recent passport tze photographs uith name and 5igPatUre at tlic hadside. (hI Nagaland Nursing Conned Registraflon Cemflcat. (c) 3Sc Degree1 Post Graduate Dcccc. Dpknna CcriiainyoLher I hereby submit a Bank Draft Nc ...,...,.... i)atcd prepared from (Bank).. ...... — for (Rupees only as non-rcfIindabk fee in favour of Nagaland Nursing Council. (in case of late fee) I hereby submit a Bank Draft No Dated ..................prepared from (Bank)..... for Rs being the late fee as none re fundable fee in favour of Nagaland Nursing Council. DECLARATION I solemnly affirm and deciate that the particulars furnished above by me arc true to the best of my knowledge and I believe and 1 undertake to abide by the code 'of Conduct & Ethics of Nagaland and Indian Nursing Council and by the Rules of Nagaland Nursing Council. Date Signature of the Applicant (FroffiCc use only) Received the above documeirs in origiiia. Signature of registered person Name: Dale 29, June, 2019 The Nagaland Gazette, Part-V 42 FORM -4 APPLICATION FOR REGISTRATION OF ADDITIONAL QUALIFICATION Receipt No Affix passport size photograph attested Date (For office use) To. The Registrar Nagaland Nursing Council Sub Registration of additional qualification Sir! Madam, I am a registered Nurse of Nagaland Nursing council and my Registration No. is - I have acquired an additional qualification in nursing and desire to register the same- My particulars arc as under. I. Name of the Application block letters