Amendment status not verified — confirm the current text below against the official source.
Draft prepared from (Bank) original certificates for verification and submit attested copies of the same I submit herewith certificates if registered elsewhere (INC and other State a) I3irth Certificate1 Matriculate Certificate / SSC Exam certificate with the date of birth. b) BSc Degree) Post Graduate Degree) Diploma1 any other C) State Nursing C0uncil indian Nursing Council Registration Certificate d) Other evidence in support of my having obtained the qualification which 1 possess Certificate from State Nursing Council "k-here ea e) No Objection rlier tegistered. 1) Three recent passport size photographs with name and signature at the backside. g) Bank Drafts Rs 2000IRs 3000- (Rupees Two,. hree Thousand only) in favour of Nagaland Nursing Council in case of fresh registration.. DECLARATION I solemnly affirm and declare that the particulars furnished above by me are true to the best of my knowledge and I believe and I undertake to abide by the c6de of Conduct & Ethics of Nagaland and Indian Nursing Council and by the Rules of Nagaland Nursing Council, Signature of the Applicant Date (For office use only) lecivved the above documents in original Signature of registered person Name.......................................... Date............................................ Date.............................. Signature of Registrar with seal Datc of Registration in fSign u ei Registrar with No • atificL. INNC, Register i seal Registration Re ewcd Date: IcnewziI seal Signature of Registrar with seal 29, June, 2019 39 The Nagaland Gazette, Part-V FORM-2 REGISTRATION (:ERTIF It Passport size photograph of the registered Nurse RcuitlOfl No This is to cemfy that 1, Mr Ms whose sign is rn the boc), son. dtgIuer wife of l3ornon......J.......................(datc month) vcnr Possessing the quatificiIiOn(S't.. ...................... has been duty rtgtstered under the Nagaland Nursing Council Act 201. 2, Mt) Ms has solemnly alThmed to abide by the niks and Regulations of Nagaland Nusing Cucil Rulc. 2019 and the ethics of Nagaland Nursing Council and Indian Nursing Council professional conduct, etiquette and ethic) Regubuon 3, In witncss thereof, the sal of the Nagaland Nursing Council and the signature of the Registrar is herewith affixed 4 Subject to the provitoo i tic said Act this certificate is valid up to a period of 5 (five) years from this date. Important Notice: I. Registered Nur5c5.,%hojod 5cnd ijiunediate notice to the Registrar of Naiaand Nursing Council if there is any change in the registered address,