Receipt of Application For G.N.M. (New Course) Registration Your Registration Application Approved By Council Application Details Application No. RG15209352 Photo-Signature Enrollment No. 07142GNMJ161112 Transaction Id 21071902193112489855 PaidStatus Paid On :- 19/07/2021 Target Date(DD/MM/YYYY) 16/12/2021 Registration Applied Sno Registration Applied CourseFee 1 G.N.M. (New Course) Rs. 1200/- Previous Registration Details Previous Registration In (RN/RM No.) %PreRegistrationIn% Previous Registration No(RN/RM No.) %PreRegistrationNo% Previous Registration from date (RN/RM No.) %PreRegistrationFromDt% Previous Registration to date (RN/RM No.) %PreRegistrationToDt% Specilization %Specilization% Personal Details Applicant Name PUSHPA KUMARI Father's/Husband Name LALURAM MAIDA Mother's Name CHAMPA MAIDA Nationality Indian MP Domicile No (Rajasthan) Gender Female Category UR Marital Status Single Date of Birth 15/04/1991 Religion Hindu Caste BHAEEL E-mail Age Mobile Number 89XXXXXX55 ,74XXXXXX44 Current Addres: PUSHPA KUMARI D/O LALURAM MAIDA, VILL/POST- BARI KATUMBI, TEH. CHHOTI SARWAN, DIST. BANSWARA (RAJ.) Pin Code-327001 Permanent Adress: PUSHPA KUMARI D/O LALURAM MAIDA, VILL/POST- BARI KATUMBI, TEH. CHHOTI SARWAN, DIST. BANSWARA (RAJ.) Pin Code-327001 Training Center Details Name of Examination University/ Council from which Qualified Madhya Pradesh Nurses Registration Council Bhopal (M.P.) Obtaining Nursing Qualification Date 18th to 19th December 2020 Training Center Balaji Nursing College (Bhopal) - [07142] Training Period From Date 10/08/2016 Training Period To Date 30/12/2019 Training Center Address BALAJI NURSING COLLEGE, KOLAR ROAD, BHOPAL Education Qualification Details Sno Examname Subject Boardname PassYear Percentage Rollnumber 1 High School (10th) ALL RAJSTHAN BOARD 2011 46.67 009846 2 Higher Secondary (12th) Geography RAJSTHAN BOARD 2013 49.40 1951004 Annexure, Testimonials & Perticulars Registration MP Nurses Council or Other Council 1. Annexure Diploma in General Nursing Qualification in Certificate of midwifery 2. Copies of Testimonials Testimonials Person 1 MR. ARVIND TIWARI (DIRECTOR) Testimonials Person 2 MISS. POONAM (PRINCIPAL) 3. Perticular Regarding Registration with the Madhya Pradesh Nurses Registration Council Bhopal or with any other Council. SNo. Description View 1 10th Marksheet * View 2 12th Marksheet * View 3 Trainning Period/Internship Certificate * View 4 First Year Marksheet * View 5 Second Year Marksheet * View 6 Third Year Marksheet * View Form Fee (Course Wise Fee +  Form Fee +Postal Charge)  1350 PrintDate:- 04/04/2026 9:18 AM Portal Charge 100 GST Tax 0 Late Fee 0 Total Fee 1450

Candidate must have to verifiy thier Original Documents of B.Sc., Post Basic B.Sc., M.Sc., LHV, A.N.M., G.N.M. from the Nursing Council. BSc Nursing Applicants Form Fee 100 /- Rs . Other Course Applicants Form Fee 50/- Rs. and PostageCharge 50/-Rs.