The accounts of the Council shall be audited at least once in each year at such date or dates as the council shall direct by an Auditor or Auditors to be nominated by the Council. A copy of the audited accounts of the Council shall be submitted to the State Government.
P. L. RISHI, President, Rajasthan Nursing Council, Jaipur.
RAJASTHAN NURSING COUNCIL 24 | P a g e RAJASTHAN NURSING COUNCIL FORM I [See Regulation 43 (1) (b)] First Examination for the General Nursing and Midwifery Course.
(This application must reach the Registrar of the Rajasthan Nursing Council on or before the.........................)
APPLICATION To, The Registrar, Rajasthan Nursing Council.
Sir/Madam, I request permission to present myself at the ensuing First Examination for the General Nursing Midwifery Course.
The fee of Rs. ………………...-is forwarded herewith.
Dated the Yours obediently, ( ) CERTIFICATE I certify that……………… has fulfilled the requirements contemplated under the prescribed regulations. In my opinion he/she is fit by his/her education, character, conduct and training to perform the duties of a nurse. His/her age on the first day of the month of examination will be to the best of my information and belief……………years-………………...months.
I further certify that he/she attended at least 75 per cent of the lectures and demonstrations.
Dated the... ... Signature of the Head of the Institution.
25 | P a g e PARTICULARS TO BE FILLED IN BY THE CANDIDATE
1. Age.
2. Date of passing the Matriculation Examination or its equivalent.
3. Language in which the candidate wishes to be examined.
PARTICULARS TO BE FILLED IN BY THE HEAD OF THE INSTITUTION
1. Candidate's name in full.
2. Candidate's Nationality.
3. Date of admission to the Institution.
4. Period of training-
(a) Anatomy and Physiology.
(b) Health Subjects (Personal and environmental hygiene, Principles and practice of health teaching, nutrition).
(c) Elementary nursing.
5. Character.
6. Conduct.
7. Health.
8. Ward work.
9. General capacity.
Dated the……………….. Signature of the Head of the Institution.
26 | P a g e RAJASTHAN NURSING COUNCIL FORM II [See Regulation 43 (2) (6)] Second Examination in General Nursing and Midwifery Course (This application must reach the Registrar of the Rajasthan Nursing Council on or before the...............).
APPLICATION To, The Registrar, Rajasthan Nursing Council.
Sir/Madam, I request permission to present myself at the ensuing Second Examination in General Nursing and Midwifery course.
The fee of Rs…………………………………is forwarded herewith.
Date the…………..….19 Yours obediently ( ) CERTIFICATE I certify that……………………… has been a Probationer Nurse at the ………………………..for a full period of three years, viz from the………………to the…………………..and that he/she has attended at least 75 per cent of lectures and passed the successive examinations in the subjects prescribed and passed the successive examinations in the subjects prescribed and has also spent not less than six months of the period on night duty.
27 | P a g e further certify that he she is trustworthy and of good moral character and his/she general conduct while under-training has been………………….
Dated the…………….19 Signature of the Head of the Institution.
Address……………………..
PARTICULARS TO BE FILLED IN BY THE CANDIDATE
1. Date of passing the Preliminary Examination in Nursing.
2. Age.
3. Language in which the candidate wishes to be examined.
PARTICULARS TO BE FILLED IN BY THE HEAD OF INSTITUTION
1. Candidate's name in full.
2. Candidate's nationality.
3. Date of admission to the Institution.
4. Period of training.
(a) General Nursing.
(b) Medical Nursing.
(c) Surgical Nursing.
(d) Gynaecological Nursing.
(e) Special subjects (Paediatrics. infectious and Tropical diseases, professional adjustments).
5. Whether trained in Nursing-men, women and children.
6. Character.
7. Conduct.
8. Health.
9. Ward work.
10. General Capacity.
Dated the…………….19 Signature of the Head of the Institution 28 | P a g e RAJASTHAN NURSING COUNCIL FORM III [See Regulation 43 (3) (b)] Final Examination for the General Nursing and Mid- wifery Certificate.
(This application must reach the Registrar of the Rajasthan Nursing Council on or before the.......................).
APPLICATION Sir/Madam, I request permission to present myself at the ensuing Final Examination for the General Nursing-Midwifery.
The fee of Rs.- is forwarded herewith.
Dated the………………….19 Yours obediently, ( ) CERTIFICATE I certify that………………….has fulfilled the require-ments contemplated under Regulations as prescribed and has attended not less than 75 per cent of lecture on and practical classes held. In my opinion she is fitted by her education, training, character and conduct to perform the duties of a midwife. I believe the subjoined account to be true. Her age on the first day of the month of the examination will be, to the best of my information and belief.
Dated the………………….19 Signature of the Head of the Institution.
PARTICULARS TO BE FILLED IN BY THE CANDIDATE
1. Age.
2. Date of passing the Second Examination.
3. Language in which the candidate wishes to be examined.
PARTICULARS TO BE FILLED IN BY THE HEAD OF THE INSTITUTION
1. Candidate's name in full.
2. Candidate's Nationality.
3. Date of admission to the Institution.
29 | P a g e
4. Period of training in Midwifery and Obstetrical Nursing.
5. Number of Labours personally conducted
6. Number of labours at which she was present.
7. Character.
8. Conduct.
9. Health.
10. Ward work.
11. General capacity.
Dated the………………….19 Signature of the Head of the Institution.
Address………………… RAJASTHAN NURSING COUNCIL FORM No. IV [See Regulation 44 (1) (b)] First Examination for the Auxiliary Nurse-Midwife Course.
(This application must reach the Registrar, Rajasthan Nursing Council on or before the........................19 APPLICATION Sir/Madam, I request permission to present myself at the ensuing First examination for the Auxiliary Nurse-Midwife Course.
The fee of Rs………………is forwarded herewth.
Dated the……………………19 Yours Obediently, PARTICULARS TO BE FILLED IN BY THE HEAD OF THE INSTITUTION.
1. Candidate's name in full (Block letters)
2. Age.
3. Nationality.
4. Date of admission to the Institution.
5. Period of training.
6. Date of passing the Preliminary Examination.3
7. The Language in which the candidate wishes to be examined.
8. The date on which the candidate last appeared (if at all).
9. Whether she has attended a full course of instruction with at least 75 percent attendance in-
(a) General Nursing.
30 | P a g e
(b) Medical Nursing.
(c) Surgical Nursing.
(d) Gynaecological Nursing.
(e) Children's Nursing.
10. Character.
11. Conduct.
12. Health.
13. Ward work.
14. General capacity.
Signature of the Head of Institution.
Dated the 19 Address………………… RAJASTHAN NURSING COUNCIL FORM V [See Regulation 44 (2) (b)] Final or Second Examination (Midwifery) for the Auxiliary Nurse- Midwife Course.
(The application must reach the Registrar, Rajasthan Nursing Council, on or before the...........).
APPLICATION Sir/Madam, I request permission to present myself at the ensuing Final Examination for the Auxiliary Nurse-Midwife Course.
The fee of Rs…………………is forwarded herewith.
Dated the Yours obediently, PARTICULARS TO BE FILLED IN BY THE HEAD OF THE INSTITUTION
1. Candidate's name in full (Block letters).
2. Candidate's nationality.
3. Age.
4. Date of admission to the Institution.
5. Period of training.
6. Date of passing the First Examination for the Certificate in. Auxiliary Nurse- Midwife Course.
7. Number of Vaginal Examination made.
8. Number of labours personally conducted.
9. Number of labours at which she was present 31 | P a g e
10. Character.
11. Conduct.
12. Health.
13. General capacity.
14. Ward work.
15. Number of weeks for which she attended at the maternity and child welfare clinic and performed domicialary midwifery work.
16. Language in which the candidate wishes to be examined.
Dated the......................19 Signature of the Head of the Institution.
Addressed................
RAJASTHAN NURSING COUNCIL FORM VI (See Regulation 45) The Registrar, Rajasthan Nursing Council, Jaipur.
Sir, I request permission to appear in Final/Second Exami- nation of Lady Health Visitor's Course to be held in- I joined the Training School- below full particulars of my training Full Name.
Father's name.
Date of birth.
Full address.
Date of passing the Matriculation Examination.
Date of passing the Midwifery Examination.
The fee of Rs.- - is sent herewith.
Yours faithfully, Signature of Candidate.
32 | P a g e Certificate of training by the authorities of the Training School.
I certify that ................... S/o/D/o........................ attended - the prescribed course laid down in the rules of Rajasthan Nurses Council for First/Second Examination of the Lady Health Visitor's Course and that she is eligible to appear in Examina- tion. She bears a good moral character.
Dated-.............................
Signature, Address RAJASTHAN NURSING COUNCIL FORM VII [See Regulation 46 (1)] Application for Registration under Section 14 read with Section 13.
(To be submitted through the Superintendent of the Institution).
I, (name in full)-..................................
(Permanent address in full).
Hereby apply to be admitted to the Register of General Nurse-Midwifery- Auxiliary Nurse-cum-Midwife and Health Visitor.
Date and place of birth.
Father's name.
Nationality.
Whether married-single-widow-separated.
Where employed or practising.
I was trained at the for-................years.............months.......................and passed the Second/Final examination in General Nursing-Midwifery or Auxiliary Midwife or Health Visitors Examination held by the Council in 19 I hereby undertake that if I am admitted to the Register I will in the practice of my profession as nurse/midwife/health visitor observe and be bound by the rules and regulations issued by the Council so far as they affect me and that if the Council shall at any time after due enquiry order my name to be removed from the Register, I will return to the Registrar my certificate..
I pay herewith the prescribed fee of Rs.....................................................
Counter Signature.
(with remarks) Superintendent. Signature 33 | P a g e RAJASTHAN NURSING COUNCIL FORM VIII [See Regulation 46 (2) and (3)] Application for registration under Section 14 read with clause (ii) and (iii) of section 13.
I, (a)............................ of (permanent address) .................................................................. now residing at...................
hereby apply to be admitted to the Register of Nurses/Midwives/Health visitors.
My nationality is........................... ................born at..................................and my present age is......................................I was trained at the (b)...............................
................. in Nursing/Midwifery/Health Vistor for a period of- - - -- - -years from................... to......................... and after passing the prescribed examination held by (c)...............................................................................................................
was registered as a............................... in the............................ Council of.................................. (d) ...................................................... in the year ................... under number ...................................................................and this registration still subsists.
In support of above I produce by registration certificate.
I hereby also undertake that if I am admitted to the Register, I will, in the practice of my profession as Nurse/Mid- wife/Health Visitor, observe and be bound by the rules and regulations issued by the Council so far as they affect me, and that the Council shall at any time after due enquiry order my name to be removed from the Register.
I will return to the Registrar the certificate of registration which may be given to me.
The prescribed fee of Rs....................... is paid herewith, Dated the 19 Signature.
(a) Name in full.
(b) Name of the institution.
(c) Name of the examining Body.
(d) State here the class or part, if any, of Nurse or Mid- wives/Health Visitor.
(e) Name the Country or State.
34 | P a g e RAJASTHAN NURSING COUNCIL (Certificate in General Nursing) FORM IX (See Regulation 47) We, the members of the Rajasthan Nursing Council, hereby certify that................................................... having undergone the pre- scribed course for not less than 3 years in Nursing of men, women and Children in a duly recognised institution and having passed the prescribed examination, is granted this Certificate in General Nursing and is qualified to practise as a Medical and Surgical Nurse.
*She/he obtained Honours at the Examination.
Signed on behalf of the Rajasthan Nursing Council.
SEAL President, Rajasthan Nursing Council.
Her/His Registration No. is.......................................................................
Dated.......................
Registrar, Rajasthan Nursing Council. Signature of the Candidate.
*These words are to be omitted in an ordinary Pass Certificate.
RAJASTHAN NURSING COUNCIL (Certificate in Midwifery) FORM X (See Regulation 47) We, the members of the Rajasthan Nursing Council, hereby certify that.................................................................................... having undergone the prescribed Course for not less than six months in midwifery in a duly recognised institution and having passed the prescribed examination, is granted this certificate in Midwifery and is qualified to practise as a Midwife.
*She obtained Honours at the Examination.
35 | P a g e Signed on behalf of the Rajasthan Nursing Council.
SEAL President, Rajasthan Nursing Council.
Her Registration No. is...................................................................
Dated,.....................
Registrar.
Rajasthan Nursing Council. Signature of the Candidate *These words are to be omitted in an ordinary Pass Certificate 36 | P a g e RAJASTHAN NURSING COUNCIL (Certificate in Auxiliary Nursing Midwifery) FORM XI (See Regulation 47) We, the members of the Rajasthan Nursing Council, hereby certify that........................................ having undergone not less than 24 months theoretical and practical training in Nursing of men, women and children and in Midwifery and Obstetrical Nursing in a duly recognised Institution and having passed the prescribed examinations, is granted this certificate in Auxiliary Nurse-Midwife and is qualified to practise under medical and nursing supervision as an Auxiliary Nurse Midwife.
*She obtained Honours at the Examination.
Signed on behalf of the Rajasthan Nursing Council.
SEAL President, Rajasthan Nursing Council.
Her Registration No. is...........................................................
Dated............................
Registrar, Rajasthan Nursing Council. Signature of the Candidate.
*These words are to be omitted in an ordinary Pass Certificate.
RAJASTHAN NURSING COUNCIL (Certificate for Lady Health Visitors) FORM XII (See Regulation 47) We, the members of the Rajasthan Nursing Council, hereby certify that........................................................... having undergone the prescribed course for not less than 2.5 years in integrated course of Lady Health Visitors in a duly recognised institution and having passed the prescribed examination, is granted this certificate in Lady Health Visitors Course and is qualified to practise as a Leady Health Visitor.
37 | P a g e SEAL President, Rajasthan Nursing Council.
Her Registration No. is...................................................................
Dated.........................................
Registrar, Rajasthan Nursing Council. Signature of the Candidate RAJASTHAN NURSING COUNCIL (Certificate of Registration) FORM XIII (See Regulation 50) This is to certify that. ..............................................of.......................... trained in....................................................
By Examination By Reciprocity has this day been registered as a Nurse (according to the provisions under section 13 of the Rajasthan Nursing Council Act of 1964) by the Rajasthan Nursing Council and is entitled to be known and styled as a REGISTERED NURSE Dated at.... .................this.............................. day of................................
Certificate No... .....................
REGISTRAR.
38 | P a g e RAJASTHAN NURSING COUNCIL (Certificate of Registration) FORM XIV (See Regulation 50) This is to certify that.............................................. of............. trained in...................................................
By Examination By Reciprocity.
has this day been registered as a Midwife (accodring to the provisions under section 13 of Rajasthan Nursing Council Act of 1964) by Rajasthan Nursing Council, and is entitled to be known and styled as a REGISTERED MIDWIFE.
Dated at................................. this...................................day of.................
Certificate No............................
REGISTRAR.
RAJASTHAN NURSING COUNCIL (Certificate of Registration) FORM XV (See Regulation 50) This is to certify that Miss/Mrs......................................... of.....................
trained in ..............................................................................................
By Examination By Reciprocity has this day been registered as a Assistant Nurse- cum- Midwife (according to the provisions under section 13 of the Rajasthan Nursing Council Act of 1964) by Rajasthan Nursing Council, and is entitled to be known and styled as a REGISTERED ASSISTANT NURSE-CUM-MIDWIFE.
39 | P a g e Dated at............................. this.......................... day of............................
Certificate No.. ..............................
REGISTRAR.
RAJASTHAN NURSING COUNCIL (Certificate of Registration) FORM XVI (See Regulation 50) This is to certify that.......................................... of............... trained in...................
By Examination By Reciprocity has this day been registered as a Lady Health Visitor (according to the provisions under section 13 of the Rajasthan Nursing Council Act of 1964) by Rajasthan Nursing Council, and is entitled to be known and styled as a REGISTERED LADY HEALTH VISITOR.
Dated at.................................. this................. day of ................................
Certificate No.. ......................
REGISTRAR