Mizoram Nursing Council

Application for the Registration under clauses (a), (b), (c), (d) and (e) of Section 13 of the Mizoram Nursing Council Act, 1990

I do hereby apply to the admitted to the Register of Nurses/Midwives/Nurse-Midwives/Health Visitors/Basic Health Workers/Auxiliary Nurse Midwives under section 13 (a), (b), (c), (d) and (e) of the Mizoram Nursing Council Act, 1990.

Name *

Father's Name *

Permanent Address *

Date of Birth *

Phone No. *

Sex *

Course Passed *

Name of the Training Institute *

Period of Training / Year of Passing *

Date of Issuing Certificate *

Examination Board/University *

Employment Status *

Place of Posting *

Designation *

Passport Photo with nurse uniform (Image: jpeg,jpg,png)*

Applicant Signature (Image: jpeg,jpg,png)*

GNM/BSc. Nursing/ANM/HW Certificate - (Original Document) (*.pdf) *

Class 10/HSLC Certificate (Original Document) (*.pdf) *

For Trained in Mizoram

Student Registration Card - (Original Document) (*.pdf) *

For Trained outside Mizoram

GNM/BSc. Nursing/ ANM Nursing Council Registration Certificate - (Original Document) (*.pdf) *

Marksheet from First Year to Final Year - (Original Document) (*.pdf) *

I, hereby undertake that if I am admitted to the Register, I will in the practice of my profession as Registered Nurse/Midwife/Nurse Midwife/Health Visitor/Basic Health Worker/Auxiliary Nurse Midwife, observe and be bound by the rules and regulations issued by the Mizoram Nursing Council shall so far as they affect me and if the Mizoram Nursing Council shall at any time after due inquiry order, my name to be removed from the Register, I will return to the Registrar my Certificate.

MNC Registration : FORM-II

Application for the Registration under clauses (a), (b), (c), (d) and (e) of Section 13 of the Mizoram Nursing Council Act, 1990

For Trained in Mizoram

For Trained outside Mizoram