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Price: Rs.

1000/-

Baba Farid University of Health Sciences


Sadiq Road, Faridkot 151203 (Pb) INDIA
For Office use only:
Received Rs./US$_________

Application for obtaining


Equivalence/Eligibility Certificate
(For admission under NRI quota only)
Session ____________
(A)

Dated __________________
Cashier

(i)

Name Mr./Miss/Mrs.________________________________________________
(In capital letters)

(ii)

Father's Name
(In capital letters)

________________________________________________

(iii)

Mother's Name
(In capital letters)

________________________________________________

(iv)

Date of Birth

________________________________________________

(v)

Admission being sought for :


(a) Course

(vi)
(B)

Receipt No. _____________

___________________

(b) Year/Session:

___________________

Country____________ Passport No. _______________

Full Address:_____________________________________________________________
(Abroad) ______________________________________________________________
______________________________________________________________
______________________________________________________________
Telephone No__________________Fax Number_________________________________
e-mail address: ___________________________________________________________

(C)

Full Address ______________________________________________________________


(India)
______________________________________________________________
______________________________________________________________
Telephone No.____________________Fax Number_______________________________
e-mail address: _____________________________________________________________

(D)

1. Examination passed _________________________(10+1/equivalent) in the year ___________ under


Roll No. _______________ from the University/Board/Institution ____________________________.

P.T.O.

2. Examination passed_______________________ (10+2/equivalent) in the year_____________under


Roll No._______________from the University/Board/Institution___________________________.
_________________________________________________________as detailed below:Subjects

Marks/Grade
Obtained
10+1

10+2

Maximum
Marks
10+1

10+2

English
Physics
Chemistry
Biology
Total(PCB)
Total(PCBE)
2.
3.

Name of the School/College _________________________________________________


Whether the institution is recognized?
Yes/No
(Please attach certificate if yes)
Whether University/ Board is recognized?
Yes/No
(Please attach proof)
Particulars of fee remitted
(i)
Amount_______________Bank Draft No__________________ Dated________________
Drawn on ____________________________Bank; payable at____________(In India).
(ii)
University Receipt No._____________Dated______________

4.
(E)

Dated________________
Enclosures:
1
10+2/equivalent examination detailed marks certificate(s)

Signature of the Applicant


5

Character/Recommendation Certificate from the Head


of the Institution last attended.

6
7
8

10+1 DMC.
NRI Proof of the candidate/Parents
Detail of Grades of qualifying examination passed.

(The certificate(s) must show the marks of


Physics, Chemistry, Biology & English)
2
3
4

Explanation Sheet of grades


Date of Birth Certificate.
10+2 or equivalent examination Pass Certificate

Note:- These documents should be original along with Photocopies duly attested by a competent authority.

______________________________________________________________________________
(i)

(ii)

(iii)

(iv)

(For Office Use Only)


Qualifying examination passed, which is equivalent to 10+2 examination of PSEB/CBSE/ICSE, as a
student of _________________________ Institution/School/College, which is recognized and from
___________________________________Board/University. This Board/University is recognized one.
Candidate has passed in such qualifying examination from a recognized institution in the subjects of
Physics, Chemistry, Biology and English separately and should have obtained 50% marks in Physics,
Chemistry, Biology (PCB) taken together.
Eligible for admission to ______________________________________________________________
__________________________________________________________________
Not eligible for admission since
he/she________________________________________________________
_______________________________________________________________________________________

Superintendent (II)
Deputy Registrar

Assistant

DEO