Application Form for Registration of New Nursing Program
Name of the Institution*
Programme Applied for*
Name of Society/Trust/Mission*
Whether the Institution is
Address of Society/Trust/Mission*
Contact No of Institution
Landline STD Code*   Number*  
Fax Number*  
Mobile No*  
Did institution have government NOC Order to start nursing program
If Yes
Letter No.*   Dated* Validity*
Did institution have Indian Nursing Council Permission
Did institution have University Permission
Number of seat approved by State Government*  
Number of seat approved by Indian Nursing Council*  
Institution is running in
Clinical Details
Name of Hospital Address Parental / Affiliated No. of Bed functioning Bed Occupancy rate Distance from institution No. of Nursing Institutions affiliated Permission letter no. & date. Validity of permission Add
Teaching Staff Details
Name Designation Qualification RN.RM No. Experience Date of Joining Name & date of leaving previous Institution. Add

The information produced above is true to best of my knowledge for enrolling my institution in Chhattisgarh Nurses Registration Council Raipur (C.G). If any above context produced myself found false than I will be responsible for rejection of my institute enrollment from Chhattisgarh Nurse's Registration Council. Raipur.

ID Proof*
ID Number*