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PROSPECTUS

FOR
ADMISSION INTO GENERALNURSING &MIDWIFERY
(G.N.M)COURSE IN GOVERNMENT
&
INC RECOGNISED PRIVATE
TRAINING CENTERS OF ODISHA

DURING THE ACADEMIC SESSION 201516

Cost of Application Form & Prospectus: Rs.500/- (Rupees Five Hundred) only

Application form & Prospectus for admission into GNM training course for the academic
session 2015-16 are available in the official website of Directorate of Nursing, Odisha&
DMET ,Odisha www.nursingodisha.nic.in & www.dmetodisha.gov.in. Intending male
and female candidates may apply online by depositing prescribed fee Rs. 500/-(Rupees Five
Hundred only) in shape of SBI Challan attached in the prospectus (annexure-II).The candidate
may avail the facility for submission of On-line application which are available at the nearest
center i.e. CSC (Common Service Centre), at Gram panchayat level/Community Health Centre at
block level/CDMO office at District level.
For any query contact:- 0674-2393840
2

Index
Sl.no

Content

Page no

Admission Calendar

II

General Information & Eligibility

III

Admission Procedure

5
6
7-15

Online registration

Online Choice Filling

Provisional Merit List, Document Verification & Choice


Locking

Provisional Seat Allotment (Round 1)

Deposition of Course Fees

Final Seat Allotment (Round 2)

List of Left Out Candidate

IV

Post Admission

Selection Committee

Annexure I

List of Institution participating in Counseling

Annexure II

SBI challan for Application Fee

Annexure III

List of Nodal Centers

Annexure IV

Cast Certificate Proforma

Annexure V

Residence/Nativity Certificate Proforma

Annexure VI

Proforma of Certificate of Sainik Board

Annexure VII

Proforma for undertaking by guardian

16-17
18
19- 23
24
25
26

Annexure VIII Proforma of physical fitness certificate.

27
28
29
30

PREFACE
Nursing is a rewarding career that offers a bright and satisfying future for young
persons who have a desire to serve people with a caring attitude. As members of a modern
health care team, nurses render a significant service in the care of the sick and in the prevention
of illness and injury. Increasing numbers of trained nurses are needed to fill responsible
positions as experts in bedside nursing services, and as researchers seeking new and better
ways of meeting the nursing needs of patients. Salary and conditions of service of nurses are
attractive compared to those in other fields of employment with similar educational requirements.
Nursing offers a challenge and opportunity to serve a fellow being. If you have the zeal and
desire for nursing, you are invited to choose this noble profession.
In order to facilitate the admission at door step in remote areas and to bring clarity in the
selection process, Govt. of Odisha have introduced submission of online application,
selection & admission into GNM course at G.P level which is praiseworthy.

ADMISSION CALENDAR

Publication of Advertisement

13.07.2015

Availability of Online Application form and


Prospectus in official website

14.07.2015 to 12.08.2015. ( The

www.nursingodisha.nic.in/www.dmetorrisa.gov.in/
www.nrhmorissa.gov.in/odisha.gov.in/

Mock registration process starts from


14.07.2015 to 16.07.2015 till 2.00 PM
after that 17.07.15 11.00 AM)
onwards the final registration process
will start.)

Last date for submission of application

12.08.2015 by 05.00 P.M

Expected date of Publication of provisional merit


list in the official website:

20.08.2015

www.nursingodisha.nic.in/www.dmetorrisa.gov.in/
www.nrhmorissa.gov.in/odisha.gov.in/

Expected date of Document Verification and choice


locking at Nodal Centres

25.08.2015 to 27.08.2015

Expected date of Reporting at nodal centers with


course fees.

02.09.2015 to 04.09.2015

Final seat allotment

10.09.2015

Reporting at nodal center With fees for 2nd round


counseling

15.09.2015

Publication of list of left out Candidate

21.09.2015

to 16.09.2015

I. GENERAL INFORMATION
-

Applications are invited for admission in General Nursing & Midwifery (GNM) 1training course in
all Government & INC approved Private G.N.M training centers for the year 2015-16 (detail list of
institutions can be found in annexure 1).

The duration of the training course is 3 years which includes theory and practical as per
prescribed syllabus of Indian Nursing Council.

Admission for all seats in government institutions & 85% of seats in private institutions
will be filled up through common merit list.

Private Institutes will adopt their own procedure for filling up 15% seats under
management quota by observing minimum eligibility criteria.

All the institutions (Govt. & Private) having INC recognition as on 31.07.2015 will be
allowed for the e-counseling process.

III. ELIGIBILITY
-

Candidate must be 17 years of age or above as on 31. 12. 2015.

The candidates must have passed


10+2 with 40% marks from CHSE Odisha or equivalent thereof however science is
preferable.
Or
10 +2/12th with 40% marks from state open schools recognized by state Govt. and
National Institute of Open School recognized by Central Govt.
Or
10+2 vocational ANM course with 40% marks from the school recognized by Indian
Nursing School.
Or
10 +2 Health Science vocational stream from a recognized CBSE Board/ State/ Center.

5% of total mark is relaxed for SC/ ST candidates.

Must have passed Odia up to M.E. standard for all Govt. school of Nursing and 85% Govt
seats in private nursing institutions recognized by INC.

Must be a domicile / permanent resident / native of Odisha but currently residing outside
Odisha.( for all Govt school of Nursing and 85% Govt seats in private nursing
institutions recognized by INC)

Both female / male candidates (10% reservation for male candidates out of total seats)
are eligible to apply.

Physically Handicapped having locomotor disability of lower limbs between 40% to


50% will be taken in to consideration. Candidates are advised to obtain their physical
handicap certificate from the competent medical authority of their district on last week of
july 2015 or first week of august 2015.

Shall be medically fit for the course (Medical certificate format in annexure -VIII)

III.
-

ADMISSION PROCEDURE

Candidates can apply for the GNM Course online by applying in the appropriate
application form available at website: www.nursingodisha.nic.in/ www.dmetorissa.gov.in/
www.nrhmorissa.gov.in/ www.odisha.gov.in on or before 12.08.2015 by 05.00 PM.

The e-counseling and admission Process involves the following steps:

Step 1
Payment of application fee & online form fill up by the candidate and
registration for User id and Password.

Step 2
Choice Filling by the Registered Candidates

Step 3
Provisional Merit List. Document Verification at Nodal Centres. The
copy of the Candidate Details, Document Details and Choice list will be
generated and signed by both Nodal Officer and Candidate.

Step 4
Round 1: Provisional Seat Allotment & publication on the
website.

Step 5
The Candidates who have been allotted seats will come to the Nodal
Centre and deposit course fees. The candidate who does not deposit
course fee within stipulated time period her/his allotted seat will be
cancelled and such candidates will be deleted from the merit list.

Step 6
Round 2: Seats not filled up in Round 1, will be filled up in the
Round 2 as per the merit list.

Step 7
Left out candidate list is prepared, verified and displayed on the website.
8

Step 1: Online Registration


ASSISTANCE:
Note: Candidate may practise with the mock application form available in the
official website www.nursingodisha.nic.in (link) before filling up the actual
application form.
The candidates finding difficult to register online can get the assistance of the
Govt. facilities like CDMO(DPMU Office), Community Health Centre(CHC) &
Common Service Center (CSC) at Gram Panchayat level .Service charges Rs. 25/only is to be paid towards filling up form at Common Service Center.
Procedure for online Registration
Payment of Non-refundable Application fees Rs. 500
only through S.B.I.Challan.
The amount is payable through SBI Challan ( given in the
annexure II)
Open the website www.nursingodishanic.in
Click on "New Registration for ANM and GNM
courses
and andand aaaandannanand
AAANMANM....................
Click "apply online" and then click on "GNM".The online
application form will be displayed.

Fill the details on the application form and click on save and
continue.

Then the candidate will be directed to generate his /her


own password.

Filling up online Application form


After login, the candidate has to fill up the following details in the form.
Personal Details, Address Details, Academic details, Challan details,
Colour Photo (20- 50 KB in jpg/jpeg) & Signature (10-20 KB in jpg/jpeg)
Snapshot of the online form given below

10

Important Note:
. The candidate is required to verify his/her personal details before submission of application
as per documentary evidence.
. The selection committee is not responsible for any omission & commission in the
submitted datas and the consequences thereafter.
. In case of discrepancies if any, the candidate may bring it to the notice of the Principal
Tutor of the Concerned Nodal Centre during the time of document verification.
. Help centers like (CSC, CHC, CDMO) Office will hand over a copy of the submitted
application form (duly signed both by the candidate & officer in-charge of the center) to the
candidate & retain the second copy for the official record.

Step 2: Online Choice Filling


Important Note:
Before choice filling in the final application form candidate may practise the mock
format available in the official website www.nursingodisha.nic.in (link).

Candidate must verify the name of the list of the institutions & total no. of seats available (AnnexureI) & fill up the choices for institutions.

The candidate can give his/her choices judiciously in order of preference from the list of
available institutions as per own wish. The candidates are advised to see the updated list of
institutions till 31.07.2015 for choice filling up for the institutions.

The candidates are permitted, if they so desire, to change or re-order (through move/swap
options) their choices, delete earlier choices and add new choices as many times til they lock
their final choices at the nodal center during document verification.

Step 3: Provisional Merit List, Document verification & Final Choice Locking
a. Provisional Merit List
-

Merit list shall be prepared on the basis of career marks.

For calculating career marks, 50% of the percentage of marks secured in HSC (10th or
equivalent examination without extra optional) and 50% of the percentage of marks secured
in CHSE (10+2 or equivalent examination without extra optional.) will be taken into
consideration.

Preferences will be given in the following order:1st 10+2 Science with Biology.
2nd 10+2 Science without Biology.
3rd 10+2 and other equivalent examination.
11

In case of more than one candidate having equal career marks, inter-se merit shall be
taken into consideration as below in order of preference.
a. Qualifying stream .
b. English marks in 10+2.
c. Seniority in date of birth.

b. Reporting at Nodal Centre for Document Verification


-

Provisionally selected candidates are required to attend the designated nodal center
(annexure III) for verification of original relevant documents, payment of course fees and
choice locking on the scheduled date and time notified on the official web-site.

During document verification at the nodal centers the candidates are required to submit
two sets of the following documents (one set original, other set self-attested photo copy).
The nodal center has to return back the original documents to the candidate after due
verification.

Documents required for verification are as follows:


1. Copy of the submitted application form duly signed by the candidate or a copy
received from the help center.
2. Original 10th (HSC) pass certificate and mark sheet issued by BSE Odisha or equivalent
thereof.
3.

10+2 pass certificate and mark sheet issued by CHSE Odisha or equivalent thereof.

4. Original College Leaving Certificate / Transfer Certificate


5. Original character /conduct certificate from the Head of the Institution last attended
6. Domicile/ Residential / Nativity Certificate from competent authority as per
Annexure-v
7. Authentic proof of passing Odiya as a subject at M.E/HSC issued by Board of
secondary education (for candidates applying for Govt. Institutions & 85% of
Govt. quota seats of Private Institutions.)
8. Original caste certificate (SC/ST candidate) issued by the competent authority.
(Annexure iv)
9. Original Physically Handicapped certificate issued by the competent medical
authority of the Dist. (in case of Physically Handicapped candidates only).
Locomotor disability of lower limbs between 40% to 50% will be taken into
consideration.
10. Original SBI Challan deposit slip, Rs.500/-(Rupees Five Hundred) only towards
application fees.
11. Two copy of self-attested recent passport size Colour photograph.
12. Original certificate of Ex-Serviceman from Rajya Sainik Board (Annexure vi)
12

13. Original Green Card (with all pages) issued by the Chief District Medical
Officer. (In case of candidate claiming for the seat under green card quota).

In case of any discrepancy(from HSC /equivalent certificate) in the green


card the candidate shall have to submit an affidavit duly sworn before the
executive magistrate failing which the Green Card reservation quota will not
be taken in to consideration

14. The original Medical Fitness certificate issued by the Govt. medical officer.
If a candidate fails to submit the original College leaving certificate
(C.L.C/ T.C) or character /conduct certificate at the time of document
verification, he/she may be admitted with an undertaking to submit the same
before the Principal Tutor of the concerned GNMTC.

Note: In case the candidate fails to produce any original document as per the prospectus,
his/her name will be deleted from the list.

C. Final Locking of Choices


- Candidate has to lock the choice as per her/his own preference at the nodal
centers immediately after verification of original documents and testimonials.
- Candidates are advised to give maximum numbers of choices in order of preference.
- The nodal centers have to handover a print out of final locked choices signed both
by the candidate and officer in charge of the nodal center.

Step 4: Provisional Seat Allotment (Round 1)


-

During this step, the seats will be allotted in the order of final merit list prepared
after the document verification and choice locking at the nodal center.

The provisional allotment


of seats will be available on the official
website www.nursingodisha.nic.in and SMS alert regarding allotment will be sent to
candidates.

Steps 5: Deposition of Course Fees at Nodal Centre


Candidate has to deposit the following fees at the nodal centre towards course fees in shape of
DD in favour of the Convener GNM selection committee payable at Bhubaneswar
13

Fees for Government institutions


1st Year
Title of the fees
Admission Fees
Rs.2250/Tuition Fees
Rs.2250/Hostel Fees
Rs.1800/Electricity Charges
Rs.900/Transportation charges
for field Rs.650/training
Identity Card
Rs.150/-(once)
Caution Money (Refundable)
Rs.1000/TOTAL
Rs.9000/-

Sr.No
1
2
3
4
5
6
7

2nd Year
Rs.2250/Rs.2250/Rs.1800/Rs.900/Rs.800/_
Rs.8000/-

s3rd Year
Rs.2250/Rs.2250/Rs.1800/Rs.900/Rs.800/_
Rs.8000/-

Besides the above the messing charge may be charged extra.


Fees for 85% Govt. quota seats under Private institutions
1

Tuition Fees (including fees towards


hospital for Clinical Training)
Total

Rs.36,000/- per
annum
Rs.36,000/-

NB:- Charges for Lodging, Boarding, Transportation, etc. shall be paid separately.
If the candidate fails to deposit the requisite fees at the nodal centre on the notified date the
name of the candidate will be deleted from the counseling process.
Step 6: Final Seat Allotment (Round 2)
-

The final allotment of seats after auto up gradation will be available on the official website
www.nursingodisha.nic.in and SMS alert regarding allotment will be sent to candidates.

Candidate has to verify the reporting date for admission from the web-side

Candidate has to report at the institution along with a copy of final seat allotment on the
scheduled date and time notified on the web-side.

In addition to the documents already submitted at nodal center, an undertaking from a Local
Guardian as per Annexure VII, should be signed by the Parent / Guardian of the candidate.

Any candidate who had previously got a seat in private institution in provisional seat
allotment and after auto up-gradation get a seat in the Govt. Institution then, the balance
course fee will be refunded.

14

Reservation of Seats (from total seats) as per Orissa Reservation of Vacancies Act:
i)

22.5% for ST,

ii) 16.25% for SC.


iii) 3% for Physically challenged
iv) 3% for Ex-servicemen
v) 5% for Green card

10% s e a t s o f ( t o t a l n o . o f s e a t s a v a i l a b l e i n G o v t . & I N C r e c o g n i z e d
Private institutions) will be reserved for male candidate.

In case of non-availability of candidates belonging to Scheduled Caste community,


Scheduled Tribe, candidates can be selected in their place and vice versa subject to other
eligibility criteria.

In case of non-availability of candidates in any of the reserved category, the seats will be
filled up from the candidate of unreserved category.

If any seats out the 85% govt. quota seats of the private institution remains vacant, then the
private institutions may be allowed to fill up those seats from the common merit list.
Step 7: List of Left out Candidates
-

In this step list of candidates, who has not been allotted the seat even after completion of
seat allotment process will be prepared.

List will be verified and displayed on the website: www.nursingodisha.nic.in

The process of counseling of the left out candidates will be notified in the official
website.

15

IV.

POST ADMISSION

A Hostel Accommodation
-

There is provision for accommodation in the G.N.M. Training Centre only for female candidates.
No provision of hostel accommodation for male candidates at Govt. institution.

Candidate may reside outside the hostel if permitted by the Director Nursing Odisha , only in
exceptional circumstances for govt institutions.

The candidates are to abide by the Rules and Regulations of the concerned Institutions and
Hostel, during the period of study.

If any of them will be found to be involved in immoral activities, unruly and undisciplined
conduct, she/he will be liable for due punishment by the concerned Principal Tutor under
intimation to the Director of Nursing, Odisha , Bhubaneswar.
B. Uniform
Selected candidates after admission have to wear uniform:

Female candidate during clinical duty - white salwar kameez with white apron with black shoes

and during field practice - Green saree / salwar kameez.


-

For male candidates, white shirt and white full pant with white apron and white socks with
black shoes during ward duty and green shirt and black pant during field duty.
C. Stipend

As per decision of Government the students those who will get admission into Government
GNM Training Schools will get a stipend of Rs. 1000/- per month.

On admission in the Training Centre N.T.I., SAIL, Rourkela, School of Nursing, NSC
Hospital, MCL, Talcher, SON IB Jharsuguda, stipend will be paid to students in each
month during the training period as per existing rules of the Government of Odisha.

But the same will be paid only on successful completion of a preliminary examination after
three months of admission and after +2 Council & H.S.C Certificate/Mark list are found
genuine on verification and also after submission of necessary agreement by their Parents/
Guardians in a Cartridge paper to refund the stipend paid to her/him if she/he will discontinue
the training.
In case a candidate fails to qualify herself / himself in the 1st preliminary examination, she /
he may be given maximum two more chances failing which her/his admission will be
cancelled and she/he will be debarred from training. In case of discontinuance from study
on any ground the stipend already received, will be recovered in full as per the provisions
of the Agreement.

16

S.C./S.T. candidates admitted into G.N.M Course in INC recognized Private Institutions
, scholarship will be borne by NHM, under Swasthya Sebika Nijukti Yojana (SSNY)
Scholarship Scheme as follows:
o Partial Scholarship as Tution Fees to SC/ST students belonging to Non-KBK
districts @ Rs.15,000/- per annum.
o Full scholarship as Tution Fees to SC/ST students belonging to KBK & KBK+
districts @ Rs.50,000/- per annum.
o Sponsored SC/ST students have to execute a bond with Government which will be
provided during admission subject to provision of funds by the appropriate
authority.
D. Vacation& Holidays ( as per INC guideline from time to time)
Out of 52 weeks in one calendar year 6 weeks are deducted in first year and
second year.

4 weeks vacation

1 week preparation leave

1 week of Examination.
*Third year: First six months = 24 weeks
* 2 weeks vacation

Second six months= 24 weeks


*1 week preparation
*1 week Examination
E. Discipline
-

Absence of a student beyond 15 days in addition to the prescribed leave will not be
allowed to rejoin again except in case of candidate admitted on health ground subject to
production of medical certificate from competent authority.

The student should not indulge herself/himself in criminal offences. If found involved in
such activities, she/he will be removed from the Training and the stipend received by her
during training period will be recovered in one installment.

If any incident of ragging comes to the notice of the authority, the concerned student shall be
given liberty to explain and if her/his explanation is not found satisfactory, the authority
would expel her from the institution.

No application for change of Training Institution during the training period will be
entertained.

17

V. SELECTION COMMITTEE.
The State Selection Committee shall consist of:1
2
3
4
5
6
7

Director Nursing, Odisha


Joint Director, Nursing, Education
Joint Director, Nursing, Clinical
Deputy Director Nursing , Odisha
Asst. Director Nursing, Education
Secretary, ON&MEB, Bhubaneswar
Registrar, ONMC, Bhubaneswar

Chairperson
Vice Chairman
Member
Member
Convener
Member
Member

The Nodal Selection Committee shall consist of:1


2
3
4
5
6

CDMO/Director Capital Hospital


Principal Tutor
Senior Tutor
Senior Tutor
District Public Health Nurse
Matron / Asst.Marton /Nursing Sister

Chair Person
Convener
Member
Member
Member
Member (Nominated by CDMO)

Selection of GNM Training Course will be under the supervision of Chair-person


& Convener of the State Selection Committee.
All disputes pertaining to the selection and admission shall fall within the jurisdiction of
Bhubaneswar only. The convener of the selection committee shall be the legal person in
whose name the selection committee may sue or may be sued.

18

Annexure - I
List of Institution participating Online Counseling & Admission
List of Government Institutions
Sl.No
1

Name of the institutions as per dt:30.06.2015


GNM School Of Nursing Government, Hospital
Dhenkanal, Orissa

No.of Seats
50

GNM School Of Nursing Government Hospital


Kalahandi, Orissa
GNM School Of Nursing Government, Hospital,
Kandhamal, Orissa
GNM School Of Nursing Government, Hospital,
Sundergarh, Orissa

60

SCB Medical College Hospital Sch.Of Nsg.Po/


M-Cuttack, 753007, Orissa

100

V S S Medical College Hospital School Of


Nursing, Burla, Sambalpur 768010, Orissa

100

3
4

50
30

Govt Of India Undertaking Institutions

Nurses Training Institute Ispat General Hospital


Rourkela, Sector-19 Sundergarh 769005, Orissa

40

General Nursing And Midwifery Training School,


Central Hospital, B Valley, Mahandi Coalflields
Ltd At Po BrajarajNagar, Jharasaguda, Orissa768216, Orissa

20

General Nursing And Midwifery TrainingSchool,


N S Ch., Talcher, At/ P O - Dera,Talcher, Pin759103 ,Orissa

30

19

List of the Private Institutions

Sl.No
1

Name of the institutions as per dt:30.06.2015


Anjaali College Of Nursing Studies At-Uttara
Chaka, P.O- KousalyagangaBhubaneswar, DisttKhurda, Orissa-751002,Orissa

No.of Seats
40

Ashwini School Of Nursing At - AshwiniHospital


Sector -1, Cda Cuttack ,Orissa
Bhagabati School Of Nursing At/Po -Padmapur,
Saragan Via: Sunhat Balasore756002 ,Orissa
Bhava Institute Of Medical Science &Research
Plot -1480, I R C Village, NayapalliBhubaneswar751015, Orissa,Orissa
Bhubaneswar
School
Of
Nursing
At
94,Dharmavihar, Po/Via - KhandagiriDist Khurda, Odisha - 751030,Orissa
Biswanath Institute Of Medical TechnologyPlot
No 360/2692, Mahadev Nagar, Lane No1,
Jharapada Bhubaneswar, Dist - Khurda,Odisha751006,Orissa
Blue Wheel Institute Of Nursing Sciences At-Chandpur, Po - Chandpur Via - Ranpur, Ps RanpurNayagarh ,Orissa
D R I E M S School Of Nursing At -Kairapari, Po
- KotsahiTangi Cuttack754022 ,Orissa

40

Gopabandhu Institute Of Medical Sci. &Research


Vill - Madhabpur, Po -Mahakalabasta Via Athgarh Cuttack754029 ,Orissa
Hitech School Of Nursing Health Park,Pandara Po
- G. G. P. Bhubaneswar751025 ,Orissa
I I M T School Of Nursing S 3 M 4, Chhend
Colony,Kalinga Sundergarh
Rourkela769015
,Orissa
JharsugudaGNM Training
College
At/PoJharsugudaJharsuguda,Orissa

40

3
4

8
9

10
11

12

20

20
40

40

20

30

60

60
20

40

13

14

15

16

17
18

19

20
21

22

23

24

25

26

Kalinga Institute Of Industrial Technology


(Deemed University Campus- V) ,A T/ P O: KI I
T Bhubaneswar - 751 024, Orissa. (KINS)
Kalinga
Nursing
School,
Kalinga
Hospital Limited,
Chandrasekharpur,Bhubaneswar-751023,Orissa
Koshala GNM
Training
School
Dhanupali,SambalpurDistSambalpur768005,
Orissa
Kuntala Devi School Of Nursing At/Po-Debatra
Colony, SamantaMargDist -Nayagarh, Orissa 752069,Orissa
Kuntala Devi School Of Nursing New BusStand
Road, Po KhurdaKhurda, Orissa752055 ,Orissa
Lord Jagannath Mission's School OfNursing Plot
No. 228/237, Sector - A, Zone -B
MancheswarIndl
Estate,
P
O
RasulgarhBhubaneswar 751010 ,Orissa
Maa Annapurna School Of Nursing Plot
No.2764/4805, Nageswar Tangi Bhubaneswar
Khurda 751002,Orissa

50

Mahima School Of Nursing At- GopalsagarP.OJagatsinghpurJagatsinghpur 754103,Orissa


Manjari Devi School Of Nursing, 208,Kharavela
Nagar,
Unit-3,Bhubaneswar-751001,
KhurdahDistt.,Orissa

20

Mothers Nursing School Plot No 120 B,Kaling


Nagar, K - 1, GhatikiaBhubaneswar,Khurda,
Odisha751003 ,Orissa
National Institute Of Medical &Management
Studies
392-A/B,
BaramundaKhurda,
Bhubaneswar - 751003,Orissa
Neelachal Institute Of Nursing School CoHousing Complex, Unit Iii KharvelNagar,Janpath
- KhordhaKhordha 751001,,Orissa
Netaji School Of Nursing Plot No. 262
(B),District Centre
ChandrasekharpurKhurdaBhubaneswar
751016
,Orissa

40

Orissa Nursing Training Institute PensionLane,


Buxi Bazar Dist Cuttack- 753001,Orissa,Orissa

20

21

60

20

30

40
60

30

40

40

20

20

27

28
29

30

31

32
33

34

35
36
37
38
39
40

41
42

43

Pallichandan School Of Nursing At/PoNimapara


(Women's College Road) Dist -Puri, Orissa752106,Orissa
PathaniSamanta Nursing Centre At- OldTown,
KaransahiDistNayagarh, Orissa
Prativa Devi School Of Nursing Plot No
79,Kharvel Nagar, Unit - Iii Bhubaneswar,Orissa 751001,Orissa
Ramadevi School Of Nursing Pattamundai (By
Pass Chak) Kendrapara DistrictKendrapara754215, Orissa,Orissa
S I E M S School Of Nursing Plot No
467,Madhusudan Nagar, Side Of New A
GColonyDist Bhubaneswar- 751012, Orissa
Sabarmati School Of Nursing At MahanadiVihar,
Po NayabazarDist Cuttack- 753004,Orissa,Orissa
Sahayoga Institute Of GNM Training CollegeAt Kasturi
Nagar,
5th
Lane,
Po/Dist
RayagadaRayagada 765001 ,Orissa
Sailabala School Of Nursing AtSailashrinibas,
Narendrakona, Po PuriTownPuri, Odisha752001,Orissa
Salandi School Of Nursing Nh - 5, MotelSquare
Tehsil - BhadrakBhadrak 756100,Orissa
Sambalpur Nursing School At- Govindtola,PoDhanupali, Sambalpur 768005 ,Orissa
Sarada Devi Institute Of Medical Science #1525,
Mahanadi Vihar Cuttack 753004,Orissa
School Of Nursing & Health Sciences, HillPatna,
Behrampur-760005,Orissa
Seva School Of Nursing At - IndrahaniNagar Po Turanga, Angul-759123, Orissa,
Shaikh
School
Of
Nursing
BaghraRoad,NearPrativa Nursing Home Ward
No-16,Baripada, Mayurbhanj, Orissa, Pin757001,Orissa

30

Shree Mahavir School Of Nursing,Gopalpur,


Cuttack-753 010,Orissa
SmtSusila
Devi
Institute
Of
NursingEducationSaiPriya
Nagar,
Near
NyrSchoolRayagadaRayagada 765001 ,Orissa

40

Sri Jagannath School Of Nursing C/O MrMukesh


Kumar Vasani, At Post KhariarRoadNuapada,
Odisha- 766105,Orissa

30

22

30
40

40

30

40
30

30

20
30
40
40
30
30

30

44
45
46
47

48

49
50

Sum Nursing School, C-51, B D A H I GDuplex,


Baramunda, Bhubaneshwar-751003,Orissa
SundergarhGNM
Training
College
AtSankaraSundargarh 770001 ,Orissa
Surya School Of Nursing At/Po - Hatadihi,Dist Kenojhar Kenojhar-758082, Orissa
Sushree Institute Of Technical Education ASchool
Of Nursing, PallishreeVihar, At/ Po-Sadaipali,
DistBalangir, Orissa-767065
Susila Devi Batakrishna Nursing School,Door No866/1379, Street: Rajpur,Nuapada, At/ Po/ DistNuapada-766105,Orissa,Orissa

75

Tulasi G N M Training Centre, Gopa,


P O Keshpura, Near T V Centre Kendrapara,Orissa
Vivekananda Institute Of Social Work &Social
Science ( V I S W A S S ) School OfNursing, P
No. 474, Pitapalli Square N H-5,P O
KumarbastKhurda 752055 ,Orissa

40

23

35
30
40

40

60

Annexure II

SBI CHALLAN
BANKS SLIP
STATE BANK OF INDIA
(POWER JYOTI ACCOUNT)

CANDIDATES SLIP
STATE BANK OF INDIA
(POWER JYOTIACCOUNT)

DEPARTMENTS SLIP
STATE BANK OF INDIA
(POWER JYOTIACCOUNT)

GNM SELECTION
COMMITTEE-CUMDIR,NURSING,ODISHA
ACCOUNT No.30760830432
Name of candidate

GNM SELECTION
COMMITTEE-CUMDIR,NURSING,ODISHA
ACCOUNT No.30760830432
Name of candidate-:

GNM SELECTION
COMMITTEE-CUMDIR,NURSING,ODISHA
ACCOUNT NO-30760830432
Name of candidate-:

Branch Name
Branch Code
Amount. Rs.500/In
words
(Rupees
Five
Hundred) only
Journal No. ..
(To be filled by Bank)

Branch Name
Branch Code
Amount. Rs.500/In words (Rupees Five
Hundred) only
Journal No. ..
(To be filled by Bank)

Branch Name
Branch Code
Amount. Rs.500/In words (Rupees Five
Hundred) only
Journal No. ..
(To be filled by Bank)

Signature of
Candidate

Signature of
Bank Officer

Signature of
Candidate

Signature of
Bank Officer

Signature of
Candidate

Signature of
Bank Officer

Fees remitting Branch may collect Rs.50/- (Rupees Fifty) only towards non-home charges from the remitter SEPARATELY.

24

Annexure III
List of Nodal Center
Sl.
No.
1

ANM TC, Balasore

Balasore, Bhadrak

ANM TC, Bolangir

Bolangir

ANM TC, Baripada

Baripada, Mayurbhanj

ANM TC, Bhawanipatna

Kalahandi, Nuapada

ANM TC, Berhampur

Gajapati

GNM TC, Berhampur

Ganjam

ANM TC, Daspalla

Nayagarh

ANM TC, Deogarh

Deogarh

ANM TC, Dhenkanal

Dhenkanal, Angul

10

ANM TC, Jaypore

Koraput,
Malkangiri,
Nabarangapur, Rayagada

11

ANM TC, Kendrapara

Kendrapara, Jajpur

12

GNM TC, Cuttack

Cuttack, Jagatsinghpur

13

ANM TC, Keonjhar

Keonjhar

14

ANM TC, Phulbani

Kandhamal

15

ANM TC, Puri

Puri

16

ANM TC, Sambalpur

Baragarh

17

GNM TC, Sambalpur

Sambalpur

18

ANM TC, Sundergarh

Sundergarh, Jharsuguda

19

ANM TC, Boudh

Boudh

20

ANM TC, Sonpur

Subarnapur

21

ANM TC, Bhubaneswar

Khurda

22

ANM TC, Bhubaneswar

Khurda

Nodal Centre

Tagging District

25

Annexure IV
CASTE CERTIFICATE
Miscellaneous Certificate No. ..

This is to certify that Sri / Smt. / Miss

Son
/
Daughter
/
Wife
of
Sri

of
Village
/
Town
..
P.S.
.
Tahasil

in the District of . in the


State of Odisha
belongs to the . Caste / Tribe which is
recognised as Scheduled Caste / Tribe under Constitution (Scheduled Caste /
Tribe) order 1950 as amended by the Scheduled Castes and Scheduled Tribes
(Amendment) orders Act 1976.
Sri / Smt. / Miss . and
..
.. family are ordinarily reside in Village /
Town

P.S.
Tahasil in the District of
.. of the State of Odisha

Full Signature of the applicant

Signature of the competent


authority
Date

Round seal of Office


Designation
officer)

26

(with

seal

of

Annexure V
FORM No. III
Office of the .. Date
..
Miscellaneous Certificate Case No. ...

RESIDENT / NATIVITY CERTIFICATE

This is to certify that Sri / Smt. / Miss

Son / Daughter / Wife of Sri

is a native of the district of


.
in the State of Orissa and he / she belongs to P.S. ... Tahasil
.... in the District of... since
. years
The certificate is being granted only for the purpose of G.N.M. Training Course 2015- 16 Odisha

Full Signature of the applicant

Signature of the competent


authority
Date

Round seal of the Office

Designation (with seal of officer)

27

Annexure - VI
GOVERNMENT OF ODISHAOFFICE OF THE ORISSA SAINIK BOARD,
BONAFIDE CERTIFICATE
1.

Certificate

that

Rank

No.
Name

Vill

P.O

P.S
Dist.

(Odisha) is a bonafide Serviceman/

Ex-serviceman
of

of

the

widow:

Indian

Army/Air

force/Navy/CRPF/BSF.(In

(Name)

case

Smt.
date of death of husband

Cause of death: Battle Casualty killed in action/death on duty attributable to Military


Service/death after discharge from Armed Forces*). He/ She been issued with Exserviceman/ Identify Card bearing Machine No._

2. Shri/Kumari

is the

dependent son/daughter of the above named Ex-serviceman/widew of serviceman/


Ex-serviceman.

His/Her

date

of

birth

is

as per his/her Birth Certificate/ SLC/Mark- sheet/


Exam. Admit Card/ Board Certificate/ Military Discharge Book/issued by
bearing

the
No.

He/She is

eligible for admission

Srl.
in

Education/

Technical Institutions in seats reserved for the children of Defence Serviceman/ Exserviceman personnel/ Defence personnel killed in action.
(*Strike out those are not applicable)
Place:
Date:
Secretary Odisha Sainik Board/
Razya Sainik/ Zilla Sainik Board
(Office Seal)

28

Annexure-VII
UNDERTAKING
(To be submitted by the selected candidates after admission in the respective Training
Centre)
I Sri / Smt. (Name of the Local Guardian)
.
Address

...
Under take to act as the Local Guardian of Miss / Smt.
. Daughter / Wife of Sri
..during her
period of study in the H.W.(F) Training Centre,
.........
I also undertake to act on behalf of the parents / husband of the said
student during the period of study in the G.N.M. Training Centre,
......... for which I have been empowered by the
parent / guardian / husband of the said student.
I further undertake to take custody of the above student as and when required by
the school authorities and to ensure that she maintains the academic discipline and
good conduct during the period of study in the aforesaid institution.
Place
..
Date

Signature in full of the Local


Guardian

ATTESTATION BY PARENT / HUSBAND / GUARDIAN


The above undertaking has been signed in my presence, I empower Sri /Smt.
...to
act as
Local Guardian of my daughter
/ wife
Miss / Smt.
during the period of her
studentship
in
the
G.N.M
.Training
Centre,
.........

Place:

Signature in full of the


Parent/Guardian/Husband

Date :
Signature in full of the Student

29

Annexure-VIII
CERTIFICATE OF PHYSICAL FITNESS IN RESPECT OF SELECTED CANDIDATES
FOR ADMISSION INTO THE GENERAL NURSING & MIDWIFERY TRAINING
COURSE-2015.
Name of the Candidate in full
Age

Sex

Height

Weight

Heart

Eye

Teeth

Liver

Lungs

Spleen

Blood Pressure

Blood

Group
Please indicate if Pregnant

(In case of female candidate) Date

of L.M.P.

(In case of female candidate)

Previous Medical History, if any

Personal

Remarks of Identification
1.
2.
I certify that I have examined the above named candidate and cannot discover that she /he has any
diseases, constitutional weakness or bodily infirmity and I consider that the candidate is physically and
mentally fit to undergo General Nursing and Midwifery Training Course under Health & F.W. Department.

SIGNATURE OF THE CANDIDATE

Signature & Seal of authorized Medical Officer


(Govt. of Odisha)

Designation
Date -

30

31

24