School of Nursing — Admission Application

Applicant Login

Enter your mobile number to start a new application or resume where you left off. Your progress is saved automatically.

Mobile Number *

An OTP has been sent to .

Enter 6-digit OTP *

1. General Information

Have you completed ANM or LHV training? *

Yes No

Full Name *

Date of Birth *

Gender *

Email Address

Blood Group *

Category *

Are you vaccinated against Hepatitis-B? *

Yes No

Dose

Date (Optional)

Father's / Guardian's Name *

Mother's Name *

Address for Communication *

State *

PIN Code *

2. Educational Information

10th / Matriculation

School Name

Board

Subjects Taken

10 Total Percentage

Passing Year

12th / Intermediate

Passed Appearing

Board / University

School / College Name

Subjects Taken

Total Marks (%)

Passing Year

English compulsory subject in 12th with 100 marks ?

Yes No

Marks Obtained in English (%)

3. Additional Information

Extra-Curricular Activities Have you done any other Nursing training before?

Yes No

Course Title (if any)

Duration

Institute Name

Family & Sponsorship

Name of person who meets your financial needs Are you a Sponsored candidate?

Yes No

Sponsorship Document *

No document

Languages & Religion

Mother Tongue

Religion

Languages you can Read

Languages you can Write

Languages you can Speak If Christian, write your Denomination

Pastor's / Elder's Name

Pastor's / Elder's Address

Health

Any major illness in past?

Yes No

Details of illness (if any)

4. Statement of Purpose

Why do you want to become a nurse? * Reason for applying to this nursing school *

After completion of your training, you will be posted in any one of the EHA hospitals to complete your service commitment.

Do you agree to the service commitment? *

Yes No

5. Upload Photo & Signature

Passport Size Photo *

No photo

Signature *

No signature

Class 10th Marksheet *

No Document

Class 12th Marksheet / Admit card / Hall Ticket *

No Document

Photo: recent passport-size colour photo with white background.
Signature: clear scan/photo of your signature on white paper.

6. Application Fee Payment

Application Fee: 800
Pay via UPI / Net Banking / Card .

Payment Already Completed

Payment Successful

7. Review & Submit

I hereby declare that the information furnished above is true to the best of my knowledge.

✓ Application Submitted!

Your application has been received. Your Application Number is .

Please save this number for future reference.