Dr. N. T. R. UNIVERSITY OF HEALTH SCIENCES, ANDHRA PRADESH,
VIJAYAWADA- 520 008.
APPLICATION FOR ISSUE OF PERMANENT DEGREE CERTIFICATE IN ADVANCE OF THE
FORTHCOMING ANNUAL CONVOCATION
NO FORMAT OTHER THAN THIS SHALL BE USED. PLEASE READ THE INSTRUCTIONS AVAILABLE AT COLLEGE OFFICE & UNIVERSITY WEBSITE BEFORE FILLING UP AND SUBMIT TO THE UNIVERSITY THROUGH THE CONCERNED PRINCIPAL, BY THOSE CANDIDATES WHO HAVE PASSED BDS EXAMINATION AND AFTER COMPLETION OF INTERNSHIP BETWEEN THE LAST AND FORTHCOMING ANNUAL CONVOCATION ONLY.
2. I a ear: .r the Father I Mother: ,
3. Details of Study:
BDS Passed in (Month & Year) :
&... Division :
College where studied & Passed :
Hall Ticket No. :
JJI of Fee Paid:
a.. Amount Rs. :
5- Peroid of Internship :
From : to
Place of the Hospital :
NAME : ADDRESS:
- PIN:
Left Hand Thumb Impression of the Candidate
b.
d.
6.
a.
h.
D. D. No.I P. 0 . No:
Bank Name :
Details of Registration done with state DCI:
Permanent Registration Number:
Date & Place of Registration:
Please affLx here
your latest passport
size photograph
(colour)
DO OTSTAPLE
OR PIN TilE
PHOTO
Signature of the Applicant:
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IMPORTAI\'T NOTE:
Please go through the STRUCI'IONS I GUIDELINES bf'ore filling ap the application, which is available with yow college
office or you can download the INSTRUCTIONS from Dr. NTR. UHS Website at : http: 1/ntruhs.ap.nie.in
Enclose the following Certificates (attested copies) in order of preference.
1. Intermediate Certificate
2. Provisional Certifieate
3. Internship Certifieate
4. Permanent Registration Certificate
5. Copies of Marks Memos of all Years (including faifed m.etnos)
6. Demand Draft of&. 2, 000/- in favour of Registrar, Dr. NTR UHS Payable at Vijayawacla.
7. U transferred from one College to another college for Internship, G. 0 . copy to be endosed.
FOR THE USE OF PRI:VClP AL'S OFFICE ONLY
Certified that the details furnished by Dr. __________________ are verified from the relevant
records and are found conc:et. The applicant has no dues to this College. Hence, there is no objection for issue of BDS Degree
to him/ her.
Station
Date:
(Signature of the Principal with Office Seal)
(NO FACSIMILE TO BE USED)
FOR THE USE OF Dr. NTR UHS EXAI\UNATIO WING
1. T. R. No : 2. Degree Certificate Sl No
3. Sl. No. & Page No. of the Degree Issue Registrar (IN ADVANCE OF)
Submitted
All the details have been verified D. D. I P'. 0. bas been sent to Finance Wing I has been temoved hy the
P.R. 0. Cell. lienee, the Permanent Degree Certificate may be issued.
Sr. Asst A. R. (Exams) D. R. (Exam)