M. B. B. S. ADMISSION

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1 SETH G. S. MEDICAL COLLEGE, PAREL, MUMBAI 12 M. B. B. S. ADMISSION H.C. (GUG) Shri/Smt.. State Merit List No. (SML No.). Selected under category Sub Caste has submitted following ORIGINAL certificates with FOUR (04) sets of Attested photo copies with admission form duly filled in the file. (A) Group 01) Admission Form 02) Allotment Letter 03) Nationality Certificate/ Valid Passport/ Domicile Certificate 04) S. S. C. Passing Certificate (10 th Std.) 05) 12 th H.S.C. Mark sheet 06) NEET Exam Mark sheet (2017) 07) Cast Certificate 08) Caste Validity Certificate 09) Non Creamy Layer Certificate (For NT 1,2,3 VJ & OBC) 10) College Leaving OR Transfer Certificate 11) Physical Handicap Certificates and others (B) Group 01) Report of Blood (Hemogram) 02) Physical Fitness Certificate 03) Migration Certificate 04) Self Educational Gap certificate (Affidavit from students) 05) Aadhar Card Copy Date : Student s Signature Clerk (GUG) H.C. (GUG)

2 UNDERTAKING To, The Dean Seth G. S. Medical College Parel, Mumbai Name State Merit List No. Category Subject: M.B.B.S. admission at Seth G. S. Medical College during the academic year Sir/Madam, I hereby agree to confirm to the rules and regulations at present in force or hereafter be made for the Administration of the College, I will do nothing unworthy of the student of the college either inside or outside or anything that will interfere with its orderly working and I have carefully read and understood criteria for eligibility for University Examination i.e. i) 75% attendance in Lectures & 80% attendance in non Lecture teaching programme, ii) Minimum of 50% score in the internal assessment in theory and practical taken together. I do hereby undertake to comply with the above-mentioned criteria and have noted that if I fail to fulfill the requirements as above, my form of application for admission to the University Examinations will not be accepted and I will not be sent up for the University Examinations. I will submit the Service agreement and surety bond as per rule for his/her admission year within 15 days from the date of issuing the form. I have also noted that hostel accommodation at this college is not available and I have to make my own arrangements of stay. Subsequent to admission & payment of fees for First term, I have to pay fees and other dues every term per notification. I have noted that, I have to keep valid Identity Card with me during College hours including exam. Time and should be produced whenever required by college authority. I have noted that, I will not allowed to fill the University examination form if I fail to pay the fees as per notification. I undertake that, I will fill up B.C. freeship/scholarship form every year i.e. June/July or immediately after result as the case may be. I have noted that I will be required to pay college tuition and other charges as per schedule with fine. I have noted that no individual intimation/letter will be send in this regard. I have kept sufficient number of certified copies of all original certificates for my use for 5 & 1/2 years as original certificates are kept in the office till completion of the Internship. The present fees are under revision and I have noted that I will have to pay the fees and other charges as per revised rate from the academic year subsequent to revision. Name of the Father/Mother/Guardian Signature Address Mobile No Signature of the candidate

3 SETH G. S. MEDICAL COLLEGE, PAREL, MUMBAI-12. GUDILIES FOR THE STUDENTS, WHO HAVE SEEKING THE ADMISSION AT SETH G.S.M. COLLEGE FOR FIRST YEAR M.B.B.S. FOR THE ACADEMIC YEAR Please follow the steps in order to complete admission procedure. 1) Submit one photocopy of the selection letter at UG Section. 2) Register your details in the register at UG Section 3) Collect photocopy of the selection letter from UG Section duly stamped for collection of Admission form which is available on Cash Counter of College Office between a.m. to 3.30 p.m. on Monday to Saturday except second and fourth Saturday and holidays. 4) Fill up the B.C. free ship form at Counter No.1 of GTR Section (For reserve category students only) 5) Arrange following original and attested Xerox copies of four set of each certificates/documents in following sequences in the College file. (A) Group 01) Admission Form 02) Allotment Letter 03) Nationality certificate / Valid Passport / Domicile Certificate 04) S.S.C. Passing certificate (for date of birth) 05) 12 th H.S.C. Mark sheet 06) NEET Exam Mark sheet (2017) 07) Caste Certificate 08) Caste Validity certificate 09) Non Creamy Layer Certificate (For NT-1, NT-2, NT-3, VJ, OBC,) 10) College Leaving OR Transfer Certificate 11) Physical Handicap Certificates and others (B) Group 01) Report of Blood (Hemogram) 02) Physical Fitness Certificate 03) Migration Certificate 04) Self Educational Gap certificate (Affidavit from students) 05) Aadhar Card Copy 6) Submit College file and get the same verified from UG Section. 7) Please collect the payment slip for payment of fees from UG Section Notice : Fees will be accepted at cash section of the college office subject to provisional eligibility from the Registrar, Maharashtra University Of Health Sciences Nashik and without prejudice to final court order in case admission is related to writ petition where in interim court order are issued and subject to submission of agreement bond within 15 days from the date of issue.

4 DETAILS OF THE FEES. Seth G. S. Medical College Parel Mumbai 12 Fee Structure of I st M.B.B.S. Student for the year Sr. No. Particular Category Open Reserve Category (Other than SC) S.C.Catego ry 1 Tution Fees 79,800/- 6, 400/- 1, 400/- 2 Deposite 4, 000/- 4, 000/- 4, 000/- 3 Gymkhana Fees 2, 705/- 2, 705/- 2, 705/- 4 University Fees 2,420/- 2,420/- 2,420/- Total 88,925/- 15,525/- 10,525/- Total Fees are paid in D.D. only in favour of Dean, Seth G. S. Medical College Payable at Mumbai 1) Submit 2 photocopies of payment receipt at UG Section. 2) Collect the service Agreement Bond from UG Section 3) For railway concession please contact to GTR Section with Identity card. 4) Submit NTS & NMS forms after admission along with sanction letter to at GTR Section. All reserve category student shall meet at GTR Section for Scholarship/Freeship. TEACHING PROGRAMME For further details on teaching programme/registration no. candidates are directed to report to the Anatomy department, 2 nd floor of this college. And for SHIDORI contact to Mr.Shripad, Pharmacology department, 1 st floor. HOSTEL FACILITIES FOR BOYS AND GIRLS Due to change in admission rules number of students from outside Mumbai has been increased, therefore demand for Hostel accommodation has also increased. In these circumstances it is not possible to consider all the requests for Hostel accommodation. The request will be considered on the basis of availability of the accommodation. Please contact Mr. Dr. Yuvaraj Bhosale (Warden Main Boys Hostel) , Dr. Sunil Kuyare (Wardan Naigaon Boys Hostel) and Dr. Snehal Desai (Warden Main Girls Hostel) and Mr. Shripad, Pharmacology Dept. 1 st Flr.

5 BOND Students are requested to go through the instruction carefully before filling the SURETY BOND AND THE SERVICE AGREEMENT. The students seeking the admission for the year , have to execute the Service Agreement / Surety Bond of Rs.10,00,000/- (Rs.Ten Lakh only). Submit the Following documents along with agreement bond in respect of sureties. 1) Income Tax Returns with Income certificate stating that income is, more than Five Lakh.(Income and Assessment year ) 2) Service Certificate, Employment Identity card,(certified Photo Copy) 3) Copy of Pan Card. 4) Photocopy of the ration card/ Telephone Bill/Rent receipt/assessment receipt/shop & Establishment certificate/ License etc. for residential proof. 5) Recent passport size Photograph. 6) In case of self-employed person not having either income tax return pan card, submit the copy of applicable license. IDENTITY CARD Identity card will be issued only after completion of all admission formalities including submission of Service Agreement Bond & Surety Bond with all requisite documents on Counter No.1 DEAN SETH G. S. MEDICAL COLLEGE H.C.- GUG Section Contact No.:

6 SETH G. S. MEDICAL COLLEGE, PAREL, MUMBAI 12 No.GUG/OD/ NOTICE Ist M.B.B.S. students have to fill and submit the Service Agreement and Surety Bond of Rs.10 lakh on counter No.2 of U.G. Section, for the academic year The Service Agreement and Surety Bond will be available at UG Section The students have to fill and submit the same on UG Section on or before one month from seeking the Ist M.B.B.S. admission without fail. Please may be noted by the students and guardians, if the student had failed to do so, he/she will not be allowed to attend the examination. INFORMATION FOR FILLING THE S.A.B. FORM 1) Before filling the Service Agreement and Surety Bond Franking should be done from any Nationalized Bank. 2) Surety : - Agreement Bond should be filled by 2 sureties, whose yearly income is more than Five lakh rupees. The details of 2 sureties :- (a) At least single parent (either father or mother) will have to give the surety to the student/s and other surety may be a relative, family friend or neighbor or any else whose income is more than Five lakh. (b) If both parents (father and mother both) income is less than Rs.5,00,000/- in that case, two other persons (may be relative, family friend or neighbor) whose yearly income is Rs.5,00,000/- are only liable to give the surety to the student/s. (c) Witness can be any person knowing the student/s. The attested xerox copies of the following documents of the sureties are required to submit with Service Agreement and Surety Bond. 1) PAN Card 2) Recent Photograph 3) Ration Card/Electricity Bill/Telephone Bill 4) Income Tax Returned Form (16 Number) for the income year and Assessment year ) Service Certificate Dean Seth G S Medical College

7 Seth G. S. Medical College Parel Mumbai 12 Fee Structure of I st M.B.B.S. Student for the year Sr. No. Particular Category Open Reserve Category (Other than SC) S.C.Catego ry 1 Tution Fees 79,800/- 6, 400/- 1, 400/- 2 Deposite 4, 000/- 4, 000/- 4, 000/- 3 Gymkhana Fees 2, 705/- 2, 705/- 2, 705/- 4 University Fees 2,420/- 2,420/- 2,420/- Total 88,925/- 15,525/- 10,525/- All Fees are paid in D.D. only in favour of Dean, Seth G. S. Medical College Payable at Mumbai

8 STUDENT S PROFILE STUDENT S PHOTOGRAPH (KINDLY FILL THE FORM IN THE CAPITAL LETTERS ONLY) QUOTA: STATE/ALL INDIA SML/UR NO. SEX; M/F DATE OF ADMISSION NAME OF THE STUDENT (in English) (AS PER HSC MARKSHEET) NAME OF THE STUDENT (in Marathi) LOCAL ADDRESS PIN: PERMANENT ADDRESS DATE OF BIRTH PLACE OF BIRTH DOMICILE STATE - MOBILE NOS:- SELF FATHER/MOTHER LAND LINE NO AADHAR CARD NO. BLODD GROUP MOTHER TOUNGE S.S.C.PASSING MARKS/OUT OF BOARD SCHOOL NAME YEAR OF PASSING H, S, C, PASSING MARKS/OUT OF BOARD COLLEGE NAME YEAR OF PASSING PCB MARKS/OUT OF/PERCENTAGE NEET MARKS ADMITTED CATEGORY STUDENT S CATEGORY SUB CASTE (ALSO FOR OPEN CANDIDATES) CASTE CERTIFICATE, VALIDITY, NON CREMY LAYER: - SUBMITTED/NOT SUBMITTED ANNUAL INCOME: FATHER MOTHER SIGNATURE: CANDIDATE FATHER

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