Terna Public Charitable Trust S

Terna Public Charitable Trust’s TERNA MEDICAL COLLEGE & HOSPITAL Sector-12,Phase-II,Nerul,Navi Mumbai -400706 Ph.27720563

Ref.No.TMC/CPS/August 2012/ Date:-18/06/2012

TPCT’s TERNA MEDICAL COLLEGE & HOSPITAL Sector -12, Phase-II, Nerul, Navi Mumbai-400 706 Te.022-27720563 Applications are invited for C.P.S. Diploma Courses, for D.Ortho, DGO, DCH, DDV, DMRE, DOMS, DA,DPB for the term Commencing from 01/08 /2012 Application forms are available in the Dean’s Office from 21/06/2012 to 13/07/2012 on payment of Rs.100. Last date of receiving application form is 13/07/2012. Written examination and interview will be held on 17/07/2012. The enrolment will be provisional and subject to approval by CPS. Visit website - www.ternamedical.org DEAN

Terna Public Charitable Trust’s TERNA MEDICAL COLLEGE & HOSPITAL Sector-12, Phase-II, Nerul,Navi Mumbai -400706 Ph.27720563 ======Ref.No.TMC/CPS/Circular/Aug.2012/2012/ Date:-14/06/2012 C I R C U L A R Admission for CPS Diploma Applications are invited for following CPS diploma courses conducted by the College of Physicians and Surgeons of Mumbai at Terna Medical College from the candidates who have passed MBBS from the recognized university and have completed internship on or before 31.07.2012. The candidate should have Permanent Registration from MMC or Gujrat Medical Council. 1. D-Ortho 2. DGO 3.DCH 4. DDV 5.DMRE 6. DOMS 7. DA 8. DPB

SCHEDULE FOR CPS DIPLOMA ENROLMENT

Sr.No Activity Date

1. Issue of Application Form 21.06.2012 2. Last day to receive application form duly filled in 13.07.2012 3. Display of Provisional list of eligible candidates. 16.07.2012 4. Written common Entrance test at 11.30am. 17.07.2012 Interview of the Candidates ( Viva) at 1.00 P.M. 5. Display of list of the selected candidates. 26.07.2012 6. Completion of the formalities of admission 27.07.2012 7. Display of Vacant Seats. 30.07.2012 8. Display of final selection list 31.07.2012 9. Term starts. 01.08.2012 The selected candidates will have to complete the formalities as instructed by Terna Medical College . They will have to work as Resident Doctor for a period of 24 months at the Terna Medical College & affiliated teaching hospitals, Nerul & NMMC Navi Mumbai . These posts are residential & candidates will have to remain present in the premises of Hospital for attending the duties round the clock. The posts are stipendary & free accommodation will be provided. The post commences from 01.08.2012.The tenure of the each post is six months. The posting is likely to be renewed every six months after evaluating the performance. The selected candidates will have to undergo medical check up. He/she will have to pay a security deposit of Rs.5000/- at the time of accepting the post. If the candidate leaves the post before completion then term will not be granted and may be liable for disciplinary action as per rules. Visit our website - www.ternamedical.org for downloading application form.

Dean Terna Medical College Nerul, Navi Mumbai. Application Form No.

Terna Public Charitable Trust’s TERNA MEDICAL COLLEGE & HOSPITAL Sector-12, Phase-II, Nerul,Navi Mumbai -400706 Ph.27720563 ======Application for the Diploma Course in______

AUGUST 2012 To, The Dean, Terna Medical College Nerul,Navi Mumbai

Name:______(Capital Letter) (Surname) (First Name) (Father’s/Husband’s)

Date of Birth: ______

Present Address ______

______

Tel.No.______Mob:______

Permanent Address ______

______

Tel No ______Mob:______

Nationality: ______Marital Status______Qualification:______

Institute:______

Whether the institute is recognized by MCI :Yes /No. Educational Qualification: Exam College/Institute Attempt University Year for Passing Percentage ______I MBBS ______

II MBBS III MBBS (Part-I) III MBBS(Part-II)

*Additional Qualification (if any)______

* Internship (Duration) from ______to______

* Maharashtra Medical Council (Permanent)Registration No ______Date_____

* Are you bonded candidate by Govt. Yes/No

* Enrolment for any other diploma Course else where (Specify)______

Applied for:______(In order of preference_ Details of first preference subject)

Final MCPS/MBBS marks: ______out of______Attempts______

Ist Preference subject marks: ______out of ______Attempts______

Details of Second preference subject

Final MCPS/MBBS marks:______out of ______Attempts______

IInd Preference subject marks:______out of ______Attempts______

Details of Third preference subject Final MCPS/MBBS marks: ______out of ______Attempts______

III rd Preference subject marks: ______out of ______Attempts______

For Office use only:- C.OTHER INFORMATION:- Post held if any a) At present:-______if Yes, give details______b) Past ______if yes give details______

c) Employed by State Govt./Zilla Parishad/Corporation etc. if any – If Yes-specified Prizes / Scholarships/Distinction if any: _____ P. G. Registration held in any subject:- Yes / No If yes details :-______

Two reference with address:-

1)______2)______

______

______Tel. No.______Tel.No.______

Place:______

Date:- Signature

I______agree with all rules and regulations. hereby declare that all information given by me in this application is true and if found inform it.

I am responsible and I shall be liable for any punishment ,including cancellation of Enrollment.

Date: Signature:

List of the documents (Attested Xerox Copies) to be submitted along with this application form.

1) Birth Certificate / S.S.C. certificate.

2) MBBS Passing Certificate

3) MBBS degree certificate

4) Internship complication certificate (University)

5) M.M.C. Registration Certificate (Permanent)

6) Submit the details at present employer ie, name of the employer, Designation

,place posting duration of post etc.

7) NOC from present employer.