KARNATAKA STATE DIPLOMA IN NURSING EXAMINATON BOARD

1st Floor,Library Block,BMCRI, Bengaluru-560 002. Ph:080-26700074/75 Fax : 080-26700034,

Website : ksdneb.org,ksdneb.net, Email : ksdneb@gmail.com

GNM ANNUAL EXAMINATION NOVEMBER - 2023 APPLICATION FORM

NAME AND ADDRESS OF THE Bangalore City School of Nursing,

INSTITUTION:

NAME OF THE COURSE: Nursing(GNM)

REGISTER NUMBER : 21DN00687

NAME OF THE CANDIDATE SWASTIKA MALIK

FATHER NAME CHANDAN MALIK

ATTENDANCE 83%

SUBJECTS APPLIED
SL NO. CLASS THEORY SUBJECT NAME APPLIED / Q P CODE CLASS PRACTICAL SUBJECT NAME APPLIED /
NOT APPLIED NOT APPLIED

1 II Medical Surgical Nursing-I Applied 9211 II Medical Surgical Nursing- Practcal Applied

2 II Medical Surgical Nursing-II Applied 9212 II Mental Health Nursing-Practcal Applied

3 II Mental Health Nursing Applied 9213 II Child Health Nursing - Practcal Applied

4 II Child Health Nursing Applied 9214

Fees need to Pay : Rs 2100

Signature of the Candidate

CERTIFICATE
(To be filled by the Principal of the School of Nursing)

Date : .............................. Fee Amt Paid Rs. .............................. Du Number .........................

I hereby certify that the Information furnished in the application is checked and found correct

Date :
Signature of the Principal with
Institution Seal