College of Nursing Admission Form

Student Full Name (as per 10th certificate) *

Date of Birth *

Identification Marks *

Father's Name/ Guardian *

Mother's Name *

Student Blood Group *

Nationality *

Religion *

Social Status *

Family Income (Lakhs Per Year)

Aadhaar Number *

Student Email ID *

Marital StatusUnmarriedMarriedDivorced

Student Mobile Number *

Emergency Contact Number *

EAMCET / NEET: Rank: *

EAMCET / NEET: Score: *

EXTRACURRICULARACTIVITIES: *

H.No. *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

For Admissions into GNM, BSc-Nursing, BSc-MLT, DMLT, BPT, MPT and MBA-Healthcare Mgt Call on: 04044885533 info.kes@kimshospitals.com