The fees payable in respect of an appeal to the State Government under section 15, sub-section
(5) of section 22, or section 24 shall be rupees twenty five.
SCHEDULE-I FORM ‘A’ (Sub-rule 11 of Rule No.5-Part II) Nomination Paper
1. Name of the Candidate in full (as appearing in the Electoral Roll).
2. Serial Number of the Candidate on the Electoral Roll.
3. Address of the candidate
4. Name and serial number on the Electroral Roll of the Proposer.
5. Name and serial number on the Electoral roll of the Seconder.
Signature of the Proposer Signature of the Seconder Declaration by the Candidate I declare that I am willing to serve on the Council if elected.
Signature of the Candidate N.B.- (1) Nomination papers which are not received on or before ……………………….. by the Returning Officer, will be invalid.
(2) The nominee should pay a sum of Rs. 50 by Cash or Money Order to the Returning Officer, which should reach the Returning Officer on or before ………………………..
Received on …………………………… at ……………………………….
Returning Officer.
SCHEDULE – I FORM ‘B’ Voting Paper [Sub-rule (19) of Rule No. 5-Part II] Register Number or Election by ……………………………………………..
Name of the Constituency …………………………………………………...
Sl.
No.
Name of Candidate. Vote
1.
2.
3.
4.
Signature of the Returning Officer Instructions:-
1. Number of vacancies to be filled are ……………………
2. Place X mark opposite the name of the candidates whom you wish to vote.
3. Every Elector shall send his individual voting paper directly to the Returning Officer.
4. Voting papers will be invalid if:-
(a) Voting paper does not bear Returning Officer’s signature or facsimile signature.
(b) The voter signs his name or writes a word or make marks on it by which it becomes recognizable as his voting paper.
(c) Number of votes recorded thereon exceeds the number of vacancies to be filled.
(d) Number of votes recorded thereon are less than the number of vacancies to be filled.
(e) If the Returning Officer receives more than one voting paper from the same voter all such voting papers shall be treated as invalid.
5. The elector shall enclose the voting paper duly filled in, in the smaller cover and enclose that cover in bigger cover supplied by the Returning Officer and shall, write his full name (which may be typewritten) and signature in the left hand corner of the bigger envelopes in the printed columns thereof. If the Elector fails to write his full name and signature the voting paper shall be invalid.
SCHEDULE-I FORM ‘C’ Form of Application for Registration.
[Rule 7 (2) Part-III] KARNATAKA NURSING COUNCIL Application for Registration.
To The Registrar, Karnataka Nursing Council, Directorate of Medical Services, Bangalore.
Sir, I, Sri/Kum/Smt …………………………………………………………. Submit my application duly filled in for registration as …………………………….. in the Karnataka Nursing Council.
Yours faithfully, (Signature of the candidate)
1. Name of the Candidate in full (in Block letters)
2. Date of birth (According to Christian Era).
3. Marital Status (Single married or widow)
4. Permanent address
5. Institution of training with dates
6. Trained in
7. Name and address of two references
8. Two marks of Identification
SCHEDULE-I FORM ‘D’ Register No.
THE KARNATAKA NURSING COUNCIL Certification of Registration NURSE (Karnataka Nurses, Midwives and Health Visitors Act, 1961) (Karnataka Act No.4 of 1962) [Rule 7(3) Part III of the Rules of the Karnataka Nursing Council] This is to certify that Shri/Smt. ……………………………………………………………..
having passed a prescribed examination in GENERAL NURSING was admitted on ……………………………………………Section, I Part ‘A’ of the Register of Nurses, Midwives and Health Visitors Act, 1961and that he/she is entitled to take and use the title of “Registered Nurse”.
…………………………………..
Registrar of the Council (seal of the Council) Bangalore Dated ……………………. 19………………
SCHEDULE-I FORM ‘E’ Register No.
THE KARNATAKA NURSING COUNCIL Certification of Registration MIDWIFE (Karnataka Nurses, Midwives and Health Visitors Act, 1961) (Karnataka Act No.4 of 1962) [Rule 7(3) Part III of the Rules of the Karnataka Nursing Council] This is to certify that Smt. ……………………………………………………………..
having passed a prescribed examination in Midwifery was admitted on ……………………………………………Section, 1 Part (B) of the Register of Nurses, maintained under the Provisions of the Karnataka Nurses, Midwives and Health Visitors Act, 1961and she is entitled to take and use the title of “REGISTERED MIDWIFE”.
…………………………………..
Registrar of the Council (seal of the Council) Bangalore Dated ……………………. 19………………
SCHEDULE-I FORM ‘F’ Register No.
THE KARNATAKA NURSING COUNCIL Certification of Registration PSYCHIATRIC NURSE (Karnataka Nurses, Midwives and Health Visitors Act, 1961) (Karnataka Act No.4 of 1962) [Rule 7(3) Part III of the Rules of the Karnataka Nursing Council] This is to certify that Sri ……………………………………………………………..
having passed a prescribed examination in Psychiatric in Nursing was admitted on ……………………………………………Section, 1 Part (c) of the Register of Nurses, maintained under the provisions of the Karnataka Nurses, Midwives and Health Visitors Act, 1961and he is entitled to take and use the title of “REGISTERED PSYCHIATRIC NURSE”.
…………………………………..
Registrar of the Council (seal of the Council) Bangalore Dated ……………………. 19………………
SCHEDULE-I Register No.
FORM ‘G’ THE KARNATAKA NURSING COUNCIL Certification of Registration HEALTH VISITORS (Karnataka Nurses, Midwives and Health Visitors Act, 1961) (Karnataka Act No.4 of 1962) [Rule 7(3) Part III of the Rules of the Karnataka Nursing Council] This is to certify that Smt. ……………………………………………………………..
having passed a prescribed examination in Health Visitor’s Course was admitted on …………………………………………… to the register of Health Visitors, maintained under the provisions of the Karnataka Nurses, Midwives and Health Visitors Act, 1961entitled to take and use the title of “REGISTERED HEALTH VISITOR”.
…………………………………..
Registrar of the Council (seal of the Council) Bangalore Dated ……………………. 19………………
SCHEDULE-I FORM ‘H’ Register no.
The Karnataka Nursing Council Registration Certificate AUXILIARY NURSE-MIDWIFE.
(Karnataka Nurses, Midwives and Health Visitors Act, 1961) (Karnataka Act No.4 of 1962) [Rule 7(3) Part III of the Rules of the Karnataka Nursing Council] This is to certify that Smt. ……………………………………………………………..
having passed a prescribed examination in Auxiliary Nurses-Midwives Course was admitted on …………………………………………… to the Register of Auxiliary Nurses-Midwives maintained under the provisions of the Karnataka Nurses, Midwives and Health Visitors Act, 1961and that she is entitled to take and use the title of “REGISTERED AUXILIARY NURSE-MIDWIFE”.
…………………………………..
Registrar of the Council (seal of the Council) Bangalore Dated ……………………. 19……………… HEALTH AND MUNICIPAL ADMINISTRATION SECRETARIAT NOTIFICATION, Bangalore, dated 30th July 1968.
S.O.1626.- In exercise of the powers conferred by sub-clause (ii) of clause (a) of sub-section (3) of section 1 of the Karnataka Nurses. Midwives and Health Visitors Act, 1961 (Karnataka Nurses, Midwives and Health Visitors Act, 1961 (Karnataka Act 4 of 1962), the Government of Karnataka hereby appoints the 16th day of August 1968 as the date on which parts II, III, V and VI And the remaining sections of Part VII of the said Act shall come into force in the whole of the State of Karnataka.
[No. PHS 22MDA 62] By Order and in the name of the Governor of Karnataka, (Sd.) B.S. Srikantiah, Secretary to Government, Health & Municipal Admn. Department.
HEALTH AND MUNICIPAL ADMINISTRATION SECRETARIAT NOTIFICATION, Bangalore, dated 30th August 1968.
S.O.1843.- In exercise of the powers conferred by sub-section (1) of section 3 of the Karnataka Nurses Mid-wives and Health Visitors Act, 1961 (Karnataka Act 4 of 19620 the government of Mysore here by establishes a Council called “the Karnataka Nursing Council” for the purpose of carrying out the provisions of the said Act.
[No. HMA 22 MDA 62] By Order and in the name of the Governor of Karnataka, B.S. SRIKANTIAH Secretary to Government, Health and Municipal Admn. Department.
HEALTH AND MUNICIPAL ADMINISTRATION SECRETARIAT ORDER.
Bangalore, dated 30th August 1968.
S.O. 1846.- In exercise o the powers conferred by sub-section (2) of section 3 f the Karnataka Nurses, Midwives and Health Visitors Act, 1961 (Karnataka Act 4 of 1962), the Government of Karnataka hereby directs that the Karnataka Nursing Council constituted in Notification No. PHS 22 MDA 62, dated 30th July 1968 shall consist of the following members namely:-
1. The director of Health and Family Planning Services in Karnataka Bangalore.
2. The Joint Director of Health Services (Medical Education) in Mysore Under clause (a) of sub-section
(2) of section 3.
3. The Superintendent of Nursing Services, Government of Karnataka.
4. Mother Mary Colman, Nurse, St-Marthas Hospital, Bangalore.
5. Mrs. P. Sumantha Kanaw, Nurse, Civil Hospital, Gulbarga.
6. Smt. P. Narayana Roa, Nurse, Civil Hospital, Belgaum.
7. Sri Chandrashekar Dambe, Nurse, Victoria Hospital, Bangalore.
8. Smt. Premalatha Gopinath, Midwife Vani Vilas Hospital, Bangalore.
9. Smt. F. Selwan, Midwife Bowring Hospital, Bangalore.
10. Smt. J. Josephine Ante, Auxiliary Nurse-Midwife, Primary Health Centre, Kodigondanahalli, Bangalore District.
11. Smt. K. Prafulla, Health Visitor Primary Health Centre, Nelamangala, Bangalore Dist.
12. The Dean, Medical College Mysore.
13. The Dean, Karnataka Medical College Hospital, Hubli.
Under the proviso to sub-section (2) of Section 3.
14. Smt. E. Pinto, Nursing Superintendent Health visitor Training Centre, Victoria Hospital Bangalore.
15. Smt. F. Madana Nursing Superintendent, Grade I Government Wenlock Hospital, Mangalore.
16. Sri M. A. Ahad, Principal, School of Nursing Victoria Hospital-Bangalore.
17. Dr. M. Gurudas, President, Indian Medical Association state Branch, Bangalore.
18. Dr. A.V. Subramanyam, Makkalabasavanna Gudi Street, Nagarthpet, Bangalore.
Under the proviso to sub-section (2) of Section 3.
19. Smt. J.N. Martin, President, T.N.A.I. State Branch, Bangalore
20. Dr. T.B. Madappa, M.B.B.S., Deputy Director of Medical Services (Retired).
21. Mrs. M.C. Dalby, 14, Wellington Street, Richmond Town, Bangalore.
Nominated under Clause (c) of sub-section (2) of section 2
22. Mrs. A. Thomas, S. D. S.
Sanatorium, Bangalore.
[No. HMA 22 MDA 62 By Order and in the name of the Governor of Karnataka B.S. SRIKANTIAH Secretary to Government.
Health and Municipal Administration Department.