Transcript
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GOVERNMENT OF TAMIL NADU

ADMISSION TO PARA MEDICAL COURSES

(PARA MEDICAL CERTIFICATE COURSES / DIPLOMA COURSES)

2009 – 2010

PAR

LAST DATE

U

GOV

MEDIC

PROSPECTUS FOR

A MEDICAL COURSES

FOR SUBMISSION OF APPLICATION

P TO 5.00 P.M. ON 20.07.2009

AT

ERNMENT …………………………….

AL COLLEGE, …………………….

COST Rs.200/=

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INSTRUCTIONS TO CANDIDATE

1. Cost of Application Form is Rs.200/- . Application form can be obtained from the Dean of all the Government Medical Colleges in person on Payment of Demand Draft for Rs.200/- which is non refundable, drawn in favour of the Dean, Govt. ……………………Medical College, ………………….. from any one of the Nationalised Banks payable at ………….. As per G.O.Ms.No: 111, Adi Dravidar and Tribal Welfare Department dated: 22.09.1998, SC / ST candidates are exempted from payment of Demand Draft for Rs.200/- They should produce an attested copy of Community Certificate issued by the appropriate Revenue authorities.

2. Before filling up of the Application form, Scrutiny form read all the instructions carefully.

3. Use separate Application form for Para Medical Certificate Courses, D.M.L.T. Course.

4. (a) Application form must be filled up by the candidate’s in their own handwriting.

(b) Scrutiny form should be filled up legibly, neatly and correctly. The information will be processed by using a computer. Any mistake committed by the candidate will prejudice the selection.

5. The Application form and other forms should not be folded. Making hole, using pin or stappler on the Scrutiny form must be totally avoided.

6. All prescribed enclosures should only be attested (Xerox copies). ORIGINAL CERTIFICATES NEED NOT BE ENCLOSED.

7. Application with enclosures received up to the last date and time specified only will be accepted.

8. Application received after the due date and time will not be considered. Any request for extension of time for submission of documents called for after the prescribed date and time will not be entertained.

9. Incomplete applications will be rejected.

10. The Dean of the Medical College cannot be held responsible for the rejection of application for delayed receipt or loss in transit on any ground.

11. Completed application forms with enclosures may be delivered in person or sent in the cover provided, by Registered post / Courier service / Speed Post to reach the Dean Govt. ……………….Medical College, ……….before 5.00 P.M on 20.07.2009

12. Any further correspondence with the Dean of the Medical College / Higher authorities will not be entertained.

13. The filled in application form should be submitted to the Medical College in which the candidate desire to join the course.

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GOVERNMENT OF TAMIL NADU DEPARTMENT OF MEDICAL EDUCATION

Govt. Medical Colleges.

ADMISSION TO PARAMEDICAL CERTIFICATE COURSES / DIPLOMA COURSES AT GOVT………………………… MEDICAL COLLEGE,………………………..

IN TAMIL NADU 2009-2010 SESSION.

PROSPECTUS 1. ELIGIBILITY

The candidate should be citizen of India.

2. NATIVITY

Candidate should be a Native of Tamil Nadu, except the candidates who have studied in the schools in the state of Tamil Nadu from 8th Standard to Plus Two, others should produce the Nativity Certificate in the format prescribed in Annexure IV from the competent authority. The candidates who are the children of parents of Tamil Nadu origin, but living in other states should also produce the Nativity certificate as mentioned above. Permanent Residence Certificate will not be accepted.

3. AGE LIMIT

1. The candidate should have completed the age of 17 years and should not have completed 30 years as on 31.12.2009 and for SC/ST it is 35 years. 2. The date of birth and age as entered in the Transfer certificate issued after completion of H.S.C.(Academic)/ vocational C.B.S.E./ I.S.C. or any other equivalent course shall alone be

accepted. 3. FOR E.C.G.,E.E.G.,AND E.M.G COURSE THE AGE LIMIT IS 17 YEARS TO 25 YEARS.

4. EDUCATIONAL QUALIFICATION : MINIMUM ELIGIBILITY

1. PARA MEDICAL CERTIFICATE COURSES. (ONE YEAR DURATION)

Candidate who have passed Higher Secondary Certificate (Academic) Examination conducted by the Tamil Nadu Higher Secondary State Board or Equivalent Board with any subjects shall be eligible for consideration for admission .

2. DIPLOMA IN MEDICAL LABORATORY TECHNOLOGY COURSE – (TWO YEARS DURATION) Candidates who have passed Higher Secondary Certificate (Academic / Vocational) Examination conducted by the Tamil Nadu Higher Secondary State Board or Equivalent Board with the following subjects in the Science Group are eligible to apply. a. Physics, Chemistry, Botany and Zoology (or) b. Physics, Chemistry, Biology with any other subject (or) c. Vocational Medical Laboratory Technician Course. 3. DIPLOMA IN REHABILITATION THERAPY COURSE – (TWO AND A HALF YEARS DURATION)

Candidate who have passed Higher Secondary Certificate (Academic) Examination conducted by the

Tamil Nadu Higher Secondary State Board or Equivalent Board with any subjects shall be eligible for consideration for admission .

Preference will be given to the candidates who have passed H.S.C. in the first appearance. If suitable candidates are not available with the first appearance , then preference will be given to candidate with less number of appearance.

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4.DIPLOMA IN RADIOLOGICAL TECHNOLOGY (DRDT / DRTT) COURSE – (TWO YEARS DURATION) FOR PRIVATE CANDIDATES – 2 YEARS

Candidates who have passed Higher Secondary Certificate (Academic / Vocational) Examination conducted by the Tamil Nadu Higher Secondary State Board or Equivalent Board with the following subjects in the Science Group are eligible to apply. a. Physics, Chemistry, Botany and Zoology (or) b. Physics, Chemistry, Biology with any other subject 5. CERTIFICATE COURSE IN E.C.G., E.E.G., AND E.M.G. ( ONE YEAR DURATION) CONDUCTED ONLY AT GOVERNMENT STANLEY HOSPITAL, CHENNAI-1.

Candidates who have passed Higher Secondary Certificate (Academic / Vocational) Examination conducted by the Tamil Nadu Higher Secondary State Board or Equivalent Board with the following subjects in the Science Group are eligible to apply. a. Physics, Chemistry, Botany and Zoology (or) b. Physics, Chemistry, Biology with any other subject 5. METHOD OF SELECTION AND ADMISSION

I. Selection will be made purely on merit basis on the aggregate of marks obtained in H.SC. and

by applying the rule of reservation. II. Ranking of the candidates will be done based on the total marks computed to a maximum of

200 in the following subjects.( D.M.L.T. Course) a) Physics and Chemistry taken together -100 Marks. b) Biology or Botany and Zoology -100 Marks. III. The Rules of Reservation shall be as follows:

Open Competition - 31 % Backward Classes - 26.5 % Backward Class Muslims - 3.5 % Most Backward Classes/ Denotified Community - 20 % Scheduled Caste - 18 % (Arundathiyar 2.8% of 18%) Scheduled Tribe - 1 %

IV However the percentage of allocation of seats for Open Competition, Backward class, Backward Class Muslims, Most Backward Class and Denotified Communities, Scheduled Caste and Scheduled Tribe or any other category under the Rule of reservation for admission shall be in accordance with the rule of reservation in force at the time of admission. V Candidates claiming admission against reservation of seats for Backward Class, Backward Class Muslims, Most Backward Class, Denotified communities and Scheduled Caste in the above course should submit a certified Xerox copy of the permanent community card showing the social status (Backward Class, Backward Class Muslims, Most Backward Class, Denotified communities and Scheduled Caste) of the applicant issued by an authorized officer of the Revenue Department of the Government of Tamil Nadu duly attested by Grade A or Grade B officer of Government of Tamil Nadu or Central Government. VI The candidates who belong to Scheduled Tribe should submit a certified xerox copy of the permanent community card obtained from the respective Revenue Divisional Officer of the revenue division duly attested by Grade A or Grade B officer of Government of Tamil Nadu or Central Government.

6. Incase where more than one candidate has secured the same number of marks in H.S.C. the tie shall be

resolved on the basis of the following factors in the order of priority. 1 For Para Medical Certificate Courses.

a. Age (Candidate elder will be preferred to the younger).

2. For Diploma in Medical Laboratory Technology Course a. Marks obtained in Vocational subjects. b. Marks obtained in Botany and Zoology (or) Biology c. Marks obtained in Chemistry and Physics. d. Age (Candidate elder will be preferred to the younger). 3. For E.C.G., E.E.G., and E.M.G. Course a. Age (Candidate elder will be preferred to the younger).

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7. a. The Register numbers of provisionally selected candidates will be published in the office of the Dean

of the respective Govt. Medical Colleges / Institution. b. Selected candidates will be called for counseling at the office of the Dean of the respective Govt.

Medical Colleges / Institution. Candidates should attend counseling at their own expense. 8. DURATION OF THE COURSES

1. Para Medical Certificate Courses - One year. 2. Diploma in Medical Laboratory Technology Course - Two years. 3. Diploma in Rehabilitation Therapy Course - Two and Half years. 4. Diploma in Radiological Technology(DRDT/DRTT) - Two years.

As per the G.O. (Rt.) No. 606, Health and Family Welfare (PME) Department dated: 01.04.2008,on completion of the above Course the students have to undergo internship training for a period of 3 months without payment of any stipend (or) collection of fees and the training will be given in the respective Govt. Medical Colleges and Hospitals/ King Institute of Preventive Medicine, Guindy, Chennai-32 as part of the course and the certificate will be issued to the students after completion of the said internship training.

9. FEES a.1) Fees prescribed for the Para Medical Certificate courses.

1) Tuition fees : Rs.200/- per annum. 2) Special fees : Rs.250/- per annum. 3) Library fees : Rs.500/- per annum. 4) Exam fees : Rs.500/- per annum. …………. Total Rs. 1450/- per annum. …………..

a.2) Fees prescribed for the Diploma in Medical Laboratory Technology Course and Diploma in Rehabilitation Therapy Course.

I Year II Year 1) Tuition fees : Rs.200/- per annum. : Rs.200/- per annum. 2) Special fees : Rs.500/- per annum. : Rs.500/- per annum. 3) Library fees : Rs.500/- per annum. --- 4) Exam fees --- : Rs.500/- per annum. …………. ………… Rs. 1200/- per annum. Rs.1200/- per annum …………. ………..

a.3) Fees prescribed for the E.C.G., E.E.G. and E.M.G. Course is Rs.2000/- p.a. b) The selected candidates should pay the above fees. However they are liable to pay any revision in fee as and when fixed by the Government / Departments. c) Fees once paid will not be refunded under any circumstances. d) Candidates discontinuing the course cannot claim / refund of fees paid. The Transfer Certificate and Conduct Certificate will be issued to the discontinued candidates by the Head of the Institutions on receipt of declaration from the student and parent that they will not request for rejoining the Course or for the return of fees paid. 10. Candidates should affix passport size photographs taken within three months prior to submission of application and duly attested by Grade A or Grade B officer of Government of Tamil Nadu or Central Government or the Head of Institution studied in the places provided in the application. Four copies of additional passport size photos of the candidates should be enclosed. 11. All the entries in the application form should be written legibly by the candidate in his / her own handwriting. The candidate should ensure that all information including the marks in the qualifying examination furnished by him / her in the application and the enclosures are correct. The candidate is informed that if after proper scrutiny of his / her application if it is found that the marks furnished by him / her in the application are not correct or any other information is found to be incorrect, then; 1. He/She will forfeit the admission no matter at whatever stage of the course he/she will be at that time. 2. Action will be taken against the candidate as per rules.

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12. No document enclosed with the application will be returned. Candidates are required to enclose only the attested Xerox copies or attested true copies of the following certificates along with the application. Attestation should have been made by Grade A or Grade B Officer of the State Government or Central Government or by Head of the institution where the candidate studied.

a. Mark sheets of H.S.C. (Academic / Vocational) examinations in an appearance or appearances including improvement examinations or equivalent examination (Both the sides of Mark Sheets should be Xeroxed)

b. Transfer certificate obtained after the completion of H.S.C (Academic / Vocational or equivalent courses).

c. Permanent Community Certificate Card. d. Nativity Certificate (Wherever necessary) e. Candidates seeking admission against Special Category seats should submit necessary certificates

obtained from Appropriate Authorities in the prescribed forms and submit them along with the application (Please see format in the Annexure-VI)

13. The selected candidates will be called for verification of certificates by the Deans of the respective Govt. Medical Colleges. Candidates will have to produce the original Mark Sheet of the qualifying examination and other original documents such as proof of age, community certificate, transfer certificate, etc at the time of verification. Selection will be cancelled if the candidates do not produce all the original documents and the original transfer certificate. 14. Those who fail to join the course on the prescribed date and time will not be eligible for admission on a later date. 15. Candidates selected for admission and his / her parent/guardian will have to sign a discipline declaration form (Annexure). Failure to sign the declaration will result in cancellation of selection. 16. Candidates who have successfully completed the course of training and the internship training will be awarded a certificate and they are not guaranteed any appointment in Government Service. However there is plenty of job opportunities in private hospitals in India and abroad. 17. Enquiry or any correspondence regarding the selection of candidates will not be entertained. 18. SYLLABUS AND EXAMINATION. a) The Candidates joining the course should pass the examinations conducted at the end of the year by the concerned authorities. The syllabus, course content, theory, practical classes, clinical training etc as framed by the concerned authorities will be followed. b) Passing in theory and practical examination and clinical training is compulsory for issue of completion certificate. c) Medium of instruction will be English. 19. Hostel facilities will not be provided and admitted candidates have to make their own arrangements for their stay. 20. No exemption from general educational qualification or age relaxation will be considered. 21. Selection for the course is only provisional. The selection and admission is liable to be cancelled at any time as and when eligibility conditions are found to be defective in addition to facts suppressed or overlooked. The right of Allotment to the selected candidates ultimately rests with the Director of Medical Education. 22. Candidates can exercise their option for the course at the time of the counseling and allotment will be subject to availability of seats. Individual request for transfer of college or change of course will not be entertained after the selection. 23. Candidates selected for admission have to undergo Medical Examination at the College to which they are allotted before the Medical Board on the date notified by the authorities of the college. Only those candidates found medically fit will be admitted and permitted to pay the fees.

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24 The Dean, Madras Medical College, Chennai-3 is the Deputy Chairman for Certified Radiological Assistant Course conducted in all Govt. Medical Colleges and Govt. approved Institutions. 25. The Chairman / Director of the Courses will have the right to enforce any of the Govt. orders / norms / guidelines / adopt suggestions on the basis of court directions issued from time to time. The Government orders issued and to be issued from time to time pertaining to any of the matters not contained in the Prospectus should be read as part and parcel of this Prospectus and such Terms and Conditions in the Government Orders are deemed to have been incorporated in the prospectus. Such Government orders will be announced on the Website and also in popular Tamil / English dailies.

26. The candidate can purchase the Application form from any of the 14 Government Medical Colleges / King Institute of Preventive Medicine, Guindy, Chennai. The filled in application form should be submitted to the Medical College in which the candidate desire to join the course. 27. SEATS RESERVED FOR PHYSICALLY HANDICAPPED 3 % of the total number of seats are reserved for Physically disabled candidates. The reservation of seats will be provided for the candidates with 40% to 70% locomotor disabilities of the lower limbs. The other conditions for admission into Para Medical Certificate Courses will be applicable as in the case of the general category. The above candidates are required to produce a certificate from the District Medical Board of the area concerned constituted for the purpose assessing the nature and the extent of disability in the format prescribed in the Annexure. The Medical Certificate issued by District Medical Board of the area concerned for this purpose is subject to the confirmation of the Expert Committee constituted by the Director of Medical Education at the time of counseling. The candidate seeking admission under this category should produce the full size photograph exhibiting the deformity. The selected candidates for PARA MEDICAL CERTIFICATE COURSES / DIPLOMA IN MEDICAL LABORATORY TECHNOLOGY COURSE will be required to undergo second Medical examination by a Medical Board constituted for the purpose by Director of Medical Education to ascertain and confirm the nature and extent of physically disability. Candidates with any other disability other than the locomotor disability of the lower limb will not be considered for admission into PARA MEDICAL CERTIFICATE COURSES / DIPLOMA IN MEDICAL LABORATORY TECHNOLOGY COURSE under this Special Category.

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DETAILS OF THE COURSES

1. CERTIFICATE COURSE IN CARDIAC SONOGRAPHY TECHNICIAN: The course deals with the Physics of Ultrasound, Cardiac Anatomy and Physiology window techniques, normal and abnormal studies etc. and practical training in Cardiac Sonography Machine. 2. CERTIFICATE COURSE IN ECG / TREAD MILL TECHNICIAN The course deals with the proper usage of ECG / Treadmill equipments relating to detection of cardiac diseases and monitoring devices in ICCU in hospitals. 3. CERTIFICATE COURSE IN EMERGENCY CARE TECHNICIAN The Course deals with the Basic Anatomy, Physiology, Bio-Chemistry, Pharmacology, Applied Medical / Surgical emergencies in Trauma Ward.

4. CERTIFICATE COURSE IN RESPIRATORY TECHNICIAN The course deals with the basic theoretical and Practical training in the treatment and patients with respiratory disorders. The Students will attend Clinical training in O.P and I.P Respiratory clinics and wards. 5. CERTIFICATE COURSE IN DIALYSIS TECHNOLOGY The Course deals with the techniques of Haemodialysis, Peritoneal dialysis and Therapies in Nephrology Depts. 6. CERTIFICATE COURSE IN ANAESTHESIA TECHNICIAN The course deals with the handling and maintaining of equipments related Anaesthesia room and operation theatre.

7. CERTIFICATE COURSE IN THEATRE TECHNICIAN The course deals with the operation theatre works. 8. CERTIFICATE COURSE IN ORTHOPAEDIC TECHNICIAN The course deals with basic training in the Casualty, Ortho Wards, Plaster room, Ambulance training and Physiotherapy department. 9. CERTIFICATE COURSE IN CARDIAC CATHETERISATION LAB. TECHNICIAN The Course deals with Radiography, Cardiac Anatomy and Physiology, Oximetry, Pressure recording calculations of Haemodynamics normal and abnormal studies etc. 10. CERTIFICATE COURSE IN PUMP TECHNICIAN The Course deals with Heart Lung Machine and basic principles of Defibrillators and Cardioversion , Artificial Pace maker etc. in Cardiology Department. 11.CERTIFIED RADIOLOGICAL ASSISTANT COURSE. The Course deals with giving basic training to operate X-ray and Radiotherapy equipments. 12. CERTIFICATE COURSE IN AUDIOMETRY

The Course deals with training lower level function – arise a comprehensive and practical oriented programme. The main objective is to generate Audiometricians who can take routine basic Audiometry. 13. CERTIFICATE COURSE IN HEARING LANGUAGE AND SPEECH The Course deals with training lower level function – arise a comprehensive and practical oriented programme. The main objective is to generate Speech and Hearing Assistants who can take routine assessment and Therapeutic management programmes for various speech, language and hearing disorders. 14. CERTIFICATE COURSE IN CLINICAL, THERAPEUTIC, NUTRITION AND FOOD SERVICE MANAGEMENT COURSE The course deals to improve dietary services in the hospitals and to impart knowledge in nutrition in order to improve the clinical and nutritional status of the patients. 15. CERTIFICATE COURSE IN E.C.G./E.E.G./ E.M.G. COURSE 16. DIPLOMA IN MEDICAL LABORATORY TECHNOLGY COURSE (2 YEARS) 17. DIPLOMA IN REHABILITATION THERAPY COURSE (2 ½ YEARS) 18. DIPLOMA IN RADIOLOGICAL TECHNOLOGY (DRDT/DRTT) COURSE ( 2 YEARS)

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ANNEXURE - I

(A) DISCIPLINE DECLARATION BY THE CANDIDATE I ………………….. the undersigned, a student selected for admission in the Course in …………………… Medical College, do hereby agree to conform from this date if I am admitted thereto the rules and regulations including those relating to the hostel laid down hereafter by the Dean for the time being of the Colleges for the due maintenance of discipline at the said College and I assure that I will not join any agitation / Strike of any kind during the course of study. I further agree to make good when called upon to do so to the Government of Tamil Nadu any damage to furniture, apparatus or other articles which may be caused by any carelessness, negligence wantonly on my part. In the presence of : Signature of Candidate STATION : Signature of Parent / Guardian DATE : Occupation and Address : (B) DISCIPLINE DECLARATION BY THE PARENT / GUARDIAN OF THE CANDIDATE I ……………………….the Parent / Guardian of Thiru/Selvi/Tmt………………..also agree that my son / daughter / ward will conform to the rules and regulations referred to above, I also further agree to make good when called upon to do so the Government, negligence wantonly on his / her part.

In the presence of : STATION : Signature of Parent / Guardian DATE : Occupation and Address : (C) DISCIPLINE DECLARATION BY THE PARENT / GUARDIAN OF THE CANDIDATE

I assure that my son / daughter / Thiru/Selvi/Tmt…………………………………. will not join any agitation / strike of any kind during the course of studies. STATION : Signature of Candidate’s Parent / Guardian DATE : Occupation and Address :

ANNEXURE – II

DECLARATION BY THE CANDIDATE FOR PAYMENT OF DUES AS A RESULT OF REVISION OF FEES AS MAY BE DECIDED BY THE GOVERNMENT FOR THE ACADEMIC YEAR 2009 – 2010 I ………………….. the undersigned, a student selected for admission in the Course in ……………………Medical College……………………. do hereby agree to pay any amount that may become due from me as and when the fee structure is revised, as may be decided by the Government Department. In the presence of : Signature of Candidate : STATION : Signature of Parent / Guardian : DATE : Occupation and Address :

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ANNEXURE - III

DECLARATION / UNDERTAKING ON ALLOTMENT AND RE-ALLOTMENT OF INSTITUTIONS OF SELECTED CANDIDATES FOR ADMISSION TO PARAMEDICAL CERTIFICATE COURSES

I ……………………….. the undersigned, a student selected for admission in the Para Medical Certificate Course in ……………..Medical College…………………….., do hereby agree to abide the Regulations prescribed in the prospectus for admission to the above course 2009 – 2010 shall not make any claim for change of course for admission to a particular College as a matter of right. In the presence of : Signature of Candidate STATION : Signature of Parent / Guardian DATE : Occupation and Address : NOTE : - to be submitted to the Head of the Institution at the time of Admission.

ANNEXURE – IV CERTIFICATE OF NATIVITY IN TAMIL NADU Certified that Thiru/ Thirumathi…………………………Parent / Guardian of Thiru/Selvi/Thirumathi…………….residing at…………………….an applicant seeking for admission to ………………………………….course in Government ……….. Medical College…………………. in Tamil Nadu is a Native of Tamil Nadu. Signature : Name and Designation : Office Seal Station : Date : Note : 1. This certificate should be issued by an officer of the Revenue department not below the rank of Tahsildar of the Taluk concerned.

2. Any Foreign national irrespective of the period of study / stay in the state will not become eligible to apply for this course. No certificate of Nativity in the state of Tamil Nadu, should therefore be issued to Nationals of other countries for this purpose.

3. The Certificate should bear the stamp of the office of the officer signing the Certificate. The certifying officers should insist clear proof of the Nativity of the Parent / Guardian of the candidate and satisfy themselves on the genuineness of the residential proof. They should particularly be careful in the case of candidates whose mother tongue is not Tamil and whose place of birth is other than Tamil Nadu.

ANNEXURE - V MEDICAL CERTIFICATE FOR ADMINISTRATION OF HEPATITIS-B VACCINATION 1. Dr…………………………………………Registration No…………………….. certify that I have this ……………………………………day of ……………………2009 administered the Hepatitis-B Vaccine to the candidate whose particulars are given below: 1. Name of the Candidate 2. Father’s Name 3. Sex 4. Age 5. Identification Marks 6. Dose I / II / III Signature of the applicant Signature of the M.O. Name and Designation Place: Official Seal Date:

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ANNEXURE - VI

MEDICAL CERTIFICATE FOR PHYSICALLY DISABLED

The District Medical Board…………………….District………………..certify that we have this …………….day of …………………2009 examined the candidate whose particulars are given below: 1. Name of the Candidate : 2. Father’s Name : 3. Sex : 4. Approximate marks : 5. Identification marks : 6. Orthopaedically handicapped : Nature of Physically Handicap 7. Extent of disability (mention the % of disability) (Upper limb function must be normal) : 8. Whether the candidate fulfills the following standard and may be considered for admission to undergo studies in Para Medical Institutions : (a) Normal Blood Pressure : (b) Mentally normal : (c) No visual and auditory handicaps : (d) No gross speech disorders : (e) Independent in ambulation with or without calipers but without walking aids : (f) Good standing balance with or without calipers but without any support : (g) Hand function within normal limits without any aid : (h) Good control over bowel and bladder : (i) Disease must be non-progressive : 9. Whether the candidate is fit to undergo Para Medical Courses : Yes / No (The Medical Board should satisfy all the criteria mentioned in the foot note before giving the fitness)

Signature of the Applicant Member Signature of Chairman of the Medical Board Place: 1 Designation

Date: 2 Office Stamp

Note: 1. Upper limbs should be normal: If it involves one lower limb it should not have more than 40% to 70% disability. If it involves both lower limbs each limb should not have more than 10% deformity.

2. The District Medical Board should give specific recommendation under (Column 9) whether the candidate is fit for admission to Para Medical Courses.

3. The above certificate should be issued only by the District Medical Board of the area concerned constituted for the purpose after due physical examination by board.

4. Certificate received without the specific recommendations (in Col.9) of the District Medical Board will not be considered for selection.

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LIST OF DISTRICTS IN TAMIL NADU NAME OF THE

DISTRICT CODE NO NAME OF THE

DISTRICT CODE NO

Chennai

01

Ramanathapuram

17

Coimbatore

02

Salem

18

Cuddalore

03

Sivagangai

19

Dharmapuri

04

Thanjavur

20

Dindugal

05

Thiruvallur

21

Erode

06

Thiruchirapalli

22

Kancheepuram

07

Thiruvannamalai

23

Kanyakumari

08

Thoothukudi

24

Karur

09

Theni

25

Krishnagiri

10

Tirunelveli

26

Madurai

11

Tiruvarur

27

Nagapatinam

12

Vellore

28

Namakkal

13

Villupuram

29

Nilgiris

14

Virudhu Nagar

30

Perambalur

15

Ariyalur

31

Pudukottai

16

Others

32

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APPENDIX

Details of Para Medical Certificate Courses conducted in the Government Medical Colleges (Revised in G.O.(Ms) No.101, Health and Family Welfare (PME) Department dated:26.03.2007 Sl.No. Name of the

Institution Name of the Certificate/Diploma Courses.

No. of

students intake.

Ratio of Male and Female intake

1. Madras Medical College, Chennai Govt. Institute of Rehabilitation Medicine,M.M.C.

1. Cardiac Sonography Technician 2. ECG/Tread Mill Technician 3. Pump Technician 4. Cardiac Catherization Lab. Technician 5. Emergency Care Technician 6. Respiratory Therapy Technician 7. Dialysis Technician 8. Anaesthesia Technician 9. Theatre Technician 10.Orthopaedic Technician 11.Certified Radiological Assistant 12. Audiometry 13. Hearing Language & Speech 14.Clinical, Therapeutic, Nutrition & Food

Service Management 15. Diploma in Rehabilitation Therapy 16.Diploma in Medical Lab. Technology 17.Diploma in Radiological Technology - DRDT DRTT Total

20 50 20 20 20 20 30 40 40 40 10

15

15

30

15

100

10

5

500

(All Female) (All Male) (All Male) 8:2 (General: Service Candidate) 10:5(General: Service Candidate) 10:5(General: Service Candidate) 2:8 (General : Service candidate) 1:4 (General : Service candidate)

2. Stanley Medical College, Chennai

1. Cardiac Sonography Technician 2. ECG/Tread Mill Technician 3. Pump Technician 4. Cardiac Catheterization Lab. Technician 5. Emergency Care Technician 6. Respiratory Therapy Technician 7. Dialysis Technician 8. Anaesthesia Technician 9. Theatre Technician 10.Orthopaedic Technician 11.Certified Radiological Assistant 12. Audiometry 13. Hearing Language & Speech 14.Clinical, Therapeutic, Nutrition & Food

Service Management 15. E.C.G/E.E.G./E.M.G. 16.Diploma in Medical Lab. Technology 17. Diploma in Radiological Technology - DRDT DRTT Total

20 50 20 20 20 20 30 40 40 40 10

15

15

15

30

100

10

5

500

(All Female) (All Male) (All Male) 8:2 (General: Service Candidate) 10:5(General: Service Candidate) 10:5(General: Service Candidate) 2:8 (General : Service candidate) 1:4 (General : Service candidate)

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3

Kilpauk Medical College, Chennai

1. Cardiac Sonography Technician 2. ECG/Tread Mill Technician 3. Emergency Care Technician 4. Respiratory Therapy Technician 5. Dialysis Technician 6. Anaesthesia Technician 7. Theatre Technician 8. Orthopaedic Technician 9. Certified Radiological Assistant 10. Audiometry 11. Hearing Language & Speech 12. Clinical, Therapeutic, Nutrition & Food Service Management 13.Diploma in Medical Lab. Technology 14. Diploma in Radiological Technology - DRDT DRTT Total

20 50 20 20 20 35 35 35 10

15

15

15

100

10

5

405

(All Female) (All Male) 8:2 (General: Service Candidate) 10:5(General: Service Candidate) 10:5(General: Service Candidate) 2:8 (General : Service candidate) 1:4 (General : Service Candidate)

4. Madurai Medical College, Madurai

1. Cardiac Sonography Technician 2. ECG/Tread Mill Technician 3. Pump Technician 4. Cardiac Catherization Lab. Technician 5. Emergency Care Technician 6. Respiratory Therapy Technician 7. Dialysis Technician 8. Anaesthesia Technician 9. Theatre Technician 10.Orthopaedic Technician 11.Certified Radiological Assistant 12.Diploma in Medical Lab. Technology 13. Diploma in Radiological Technology - DRDT DRTT Total

20 50 20 20 20 20 20 35 35 35 10

100

10

5

400

(All Female) (All Male) (All Male) 8:2 (General: Service Candidate) 2:8 (General : Service candidate) 1:4 (General : Service Candidate)

5.

Thanjavur Medical College, Thanjavur.

1. Cardiac Sonography Technician 2. ECG/Tread Mill Technician 3. Emergency Care Technician 4. Respiratory Therapy Technician 5. Dialysis Technician 6. Anaesthesia Technician 7. Theatre Technician 8.Orthopaedic Technician 9.Certified Radiological Assistant 10.Diploma in Medical Lab. Technology 11. Diploma in Radiological Technology - DRDT DRTT Total

20 50 20 20 20 35 35 35 10

100

10

5

360

(All Female) (All Male) 8:2 (General: Service Candidate) 2:8 (General : Service candidate) 1:4 (General : Service Candidate)

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6.

Coimbatore Medical College, Coimbatore.

1. Cardiac Sonography Technician 2. ECG/Tread Mill Technician 3. Emergency Care Technician 4. Respiratory Therapy Technician 5. Dialysis Technician 6. Anaesthesia Technician 7. Theatre Technician 8.Orthopaedic Technician 9.Certified Radiological Assistant 10.Diploma in Medical Lab. Technology 11. Diploma in Radiological Technology - DRDT DRTT Total

20 50 20 20 20 35 35 35 10

100

10

5

360

(All Female) (All Male) 8:2 (General: Service Candidate) 2:8 (General : Service candidate) 1:4 (General : Service Candidate)

7. Tirunelveli Medical College, Tirunelveli.

1. ECG/Tread Mill Technician 2. Emergency Care Technician 3. Respiratory Therapy Technician 4. Dialysis Technician 5. Anaesthesia Technician 6. Theatre Technician 7.Orthopaedic Technician 8.Certified Radiological Assistant 9. Diploma in Medical Lab. Technology 10. Diploma in Radiological Technology - DRDT DRTT Total

50 20 20 20 35 35 35 10

100

10

5

340

(All Male) 8:2 (General: Service Candidate) 2:8 (General : Service candidate) 1:4 (General : Service Candidate)

8. Chengalpattu Medical College, Chengalpattu.

1. Emergency Care Technician 2. Respiratory Therapy Technician 3 Anaesthesia Technician 4. Theatre Technician 5.Orthopaedic Technician 6.Certified Radiological Assistant 7.Diploma in Medical Lab. Technology Total

20 20 35 35 35 10

100

255

(All Male) 8:2 (General: Service Candidate)

9. Govt. Mohan Kumaramangalam Medical College, Salem

1. ECG/Tread Mill Technician 2. Emergency Care Technician 3. Respiratory Therapy Technician 4. Dialysis Technician 5. Anaesthesia Technician 6. Theatre Technician 7.Orthopaedic Technician 8.Certified Radiological Assistant 9.Diploma in Medical Lab. Technology 10. Diploma in Radiological Technology – DRDT DRTT Total

50 20 20 20 35 35 35 10

100

10

5

340

(All Male) 8:2 (General: Service Candidate) 2:8 (General : Service candidate) 1:4 (General : Service Candidate)

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10 K.A.P.Viswanatham

Medical College, Trichy.

1. Emergency Care Technician 2. Respiratory Therapy Technician 3. Dialysis Technician 4. Anaesthesia Technician 5. Theatre Technician 6.Orthopaedic Technician 7.Certified Radiological Assistant 8.Diploma in Medical Lab. Technology 9. Diploma in Radiological Technology DRDT DRTT Total

20 20 20 35 35 35 10

100

10

5

290

(All Male) 8:2 (General: Service Candidate) 2:8 (General : Service candidate) 1:4 (General : Service Candidate)

11 Thoothukudi Medical College, Thoothukudi.

1. Emergency Care Technician 2. Respiratory Therapy Technician 3. Anaesthesia Technician 4. Theatre Technician 5.Orthopaedic Technician 6.Certified Radiological Assistant 7.Diploma in Medical Lab. Technology Total

20 20 35 35 35 10

100

255

(All Male) 8:2 (General: Service Candidate)

12.

Kanya kumari Medical College, Nagercoil

1. Emergency Care Technician 2. Respiratory Therapy Technician 3. Anaesthesia Technician 4. Theatre Technician 5.Orthopaedic Technician 6.Certified Radiological Assistant 7.Diploma in Medical Lab. Technology Total

20 20 35 35 35 10

100

255

(All Male) 8:2 (General: Service Candidate)

13.

Vellore Medical College, Vellore

1. Emergency Care Technician 2. Respiratory Therapy Technician 3. Anaesthesia Technician 4. Theatre Technician 5.Orthopaedic Technician 6.Certified Radiological Assistant 7.Diploma in Medical Lab. Technology Total

20 20 35 35 35 10

100 255

(All Male) 8:2 (General: Service Candidate)

14. Theni Medical College, Theni.

1. Emergency Care Technician 2. Respiratory Therapy Technician 3. Anaesthesia Technician 4. Theatre Technician 5.Orthopaedic Technician 6.Certified Radiological Assistant 7.Diploma in Medical Lab. Technology Total

20 20 35 35 35 10

100 255

(All Male) 8:2 (General: Service Candidate)

15. King Institute of Preventive Medicine, Guindy, Chennai-32

Diploma in Medical Lab. Technology course

50

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ANNEXURE LIST SHOWING THE SCHEDULED CASTES, SCHEDULED TRIBES, MOST BACKWARD CLASSES & DENOTIFIED COMMUNITIES, BACKWARD CLASSES, BACKWARD CLASSES MUSLIMS, IN THE STATE OF TAMILNADU UNLESS AND OTHERWISE SPECIFIED

****** LIST OF BACKWARD CLASSES, BACKWARD MUSLIMS,MOST BACKWARD CLASSES AND

DENOTIFIED COMMUNITIES

1. G.O. Ms. No.85, BC & MBC&MW Department dated: 29-07-2008. 2. G.O. Ms.No.96, BC & MBC&MW Department dated: 08-09-2008. 3. G.O. Ms. No. 97, BC, MBC & MW Department, Dated : 11-09-2008. 4. Tamil Nadu Act 51 of 2008.

Code No. I. LIST OF BACKWARD CLASSES

1. Agamudayar including Thozhu or Thuluva Vellala. 2. Agaram Vellan Chettiar. 3. Alwar, Azhavar and Alavar (in Kanniyakumari District and Shenkottah taluk of Tirunelveli District) 4. Servai (except Tiruchirapalli, Karur, Perumbalur and Pudukottai Districts). 5. Nulayar (in Kanniyakumari District and Shenkottah taluk of Tirunelveli District). 6. Archakarai Vellala. 7. Aryavathi (in Kanniyakumari District and Shenkottah taluk of Tirunelveli District). 8. Ayira Vaisyar. 9. Badagar. 10. Billava 11. Bondil 12. Boyas (except Tiruchirappalli, Karur, Perambalur, Pudukottai, The Nilgiris, Salem, Namakkal and

Dharmapuri and Krishnagiri Districts). Pedda Boyar (except Tiruchirapalli, Karur, Perambalur and Pudukottai Districts). Oddars (except Thanjavur, Nagapattinam, Thiruvarur, Tiruchirapalli, Karur, Perambalur, Pudukottai, Madurai, Theni and Dindigul Districts). Kaloddars (except Kancheepuram, Tiruvallur, Ramanathapuram, Sivagangai, Virudhunagar, Madurai, Theni, Dindigul, Pudukottai, Tiruchirapalli, Karur, Perambalur, Tirunelveli, Thoothukudi, Salem and Namakkal Districts). Nellorepet Oddars (except Vellore and Tiruvannamalai Districts). Sooramari Oddars (except Salem and Namakkal Districts).

13 Chakkala (except Sivagangai, Virudhunagar, Ramanathapuram, Thanjavur, Nagapattinam, Thiruvarur, Pudukottai, Tiruchirapalli, Karur, Perambalur, Madurai, Theni, Dindigul and the Nilgiris Districts).

14. Chavalakarar (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District). 15. Chettu or Chetty (including Kottar Chetty, Elur Chetty, Pathira Chetty, Valayalchetty, Pudukkadai Chetty

(in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District). 16. Chowdry. 16A. Converts to Christianity from Scheduled Caste irrespective of the generation of conversion for the purpose

of reservation of seats in Educational Institutions and for seats in Public Services. 16B. C.S.I formerly S.I.U.C. (in Kanyakumari District and Shenkottah Taluk of Tirunelveli District) 17. Donga Dasaris (except Kancheepuram, Tiruvallur, Tiruchirapalli, Karur, Perambalur, Pudukottai, Chennai,

Salem arid Namakkal Districts). 18. Devangar, Sedar. 19. Dombs (except Pudukottai, Tiruchirapalli, Karur and Perambalur Districts). Dommars (except

Thanjavur, Nagapattinam, Thiruvarur, Pudukottai, Vellore and Tiruvannamalai Districts). 20. Enadi 21. Ezhavathy (in Kanniyakumari District and Shenkottali Taluk of Tirunelveli District). 22. Ezhuthachar (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District). 23. Ezhuva (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District). 24. Gangavar 25. Gavara, Gavarai and Vadugar (Vaduvar) (other than Kamma, Kapu, Balija and Reddi). 26. Gounder 27. Gowda (including Gammala, Kalali and Anuppa Gounder). 28. Hegde. 29. Idiga. 30. Illathu Pillaimar, llluvar, Ezhuvar and Illathar.

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31. Jhetty 32. Jogis (except Kancheepuram, Tiruvallur, Madurai, Theni, Dindigul, Cuddalore, Villupuram, Vellore and

Tiruvannamalai Districts). 33. Kabbera. 34. Kaikolar, Sengunthar. 35. Kaladi (except Sivagangai, Virudhunagar, Ramanathapuram, Madurai, Theni, Dindigul,

Thanjavur,Nagapattinam, Thiruvarur, Pudukottai, Tiruchirapalli, Karur and Perambalur Districts). 36. Kalari Kurup including Kalari Panicker (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli

District). 37. Kalingi. 38. Kallar. Easanattu Kallar. Gandarvakottai Kallars (Except Thanjavur, Nagapattinam, Thiruvarur and

Pudukottai Districts). Kootappal Kallars (Except Pudukottai, Tiruchirapalli, Karur and Perambalur Districts). Piramalai Kallars (Except Sivagangai, Virudhunagar, Ramanathapuram, Madurai, Theni Dindigul, Pudukottai, Thanjavur, Nagapattinam and Thiruvarur Districts). Periya Sooriyur Kallars (Except Tiruchirapalli, Karur, Perambalur and Pudukottai Districts).

39. Kallar Kula Thondaman. 40. Kalveli Gounder. 41. Kambar 42. Kammalar or Viswakarma, Viswakarmala (including Thattar, Porkollar, Kannar, Karumar, Kollar, Thacher,

Kal Thacher, Kamsala and Viswabrahmin). 43. Kani, Kanisu, Kaniyar Panikkar. 44. Kaniyala Vellalar. 45. Kannada Saineegar, Kannadiyar (Through out the State) and Dasapalanjika (Coimbatore, Erode and the

Nilgiris Districts). 46. Kannadiya Naidu. 47. Karpoora Chettiar. 48. Karuneegar (Seer Karuneegar, Sri Karuneegar, Sarattu Karuneegar, Kaikatti Karuneegar, Mathuvazhi

Kanakkar, Sozhi Kanakkar and Sunnambu Karuneegar). 49. Kasukkara Chettiar. 50. Katesar, Pattamkatti. 51. Kavuthiyar. 52. Kerala Mudali. 53. Kharvi. 54. Khatri. 55. Kongu Vaishnava. 56. Kongu Vellalars (including Vellala Gounder, Nattu Gounder, Narambukkatti Gounder, Tirumudi Vellalar,

Thondu Vellalar, Pala Gounder, Poosari Gounder, Anuppa Vellala Gounder, Padaithalai Gounder, Chendalai Gounder, Pavalankatti Vellala Gounder, Pala Vellala Gounder, Sanku Vellala Gounder and Rathinagiri Gounder).

57. Koppala Velama. 58. Koteyar 59. Krishnavaka (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District). 60. Kudikara Vellalar. . 61. Kudumbi (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District). 62. Kuga Vellalar. 63. Kunchidigar. 63A.Latin Catholics except Latin Catholic Vannar (in Kanniyakumari District) 63B.Latin Catholics in Shenkottah Taluk of Tirunelveli District 64. Lambadi. 65. Lingayat (Jangama) 66. Mahratta (Non-Brahmin) (including Namdev Mahratta) 67. Malayar 68. Male 69. Maniagar 70. Maravars (Except Thanjavur, Nagapattinam, Thiruvarur, Pudukottai, Ramanathapuram, Sivagangai,

Virudhunagar, Tirunelveli and Thoothukudi Districts). Karumaravars Appanad Kondayam Kottai Maravars (Except Sivagangai, Virudhunagar, Ramanathapuram, Madurdi, Theni and Dindigul Districts). Sembanad Maravars (Except Sivagangai, Virudhunagar and Ramanathapuram Districts).

71. Moondrumandai Enbathunalu (84) Ur. Sozhia Vellalar.

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72. Mooppan. 73. Muthuraja, Muthuracha, Muttiriyar, Muthiriyar, Mutharaiyar. 74. Nadar, Shanar and Grarnani including Christian Nadar, Christian Shanar and Christian Gramani. 75. Nagaram 76. Naikkar (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District). 77. Nangudi Vellalar 78. Nanjil Mudali (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District). 79. Odar (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District). 80. Odiya. 81. Oottruvalanattu Vellalar. 82. O.P.S. Vellalar. 83. Ovachar. 84. Paiyur Kotta Vellalar. 85. Pamulu. 86. Panar (except in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District where the

community is a Scheduled caste). 86A. Pandiya Vellalar 87. Omitted 88. Kathikarar in Kanniyakumari District. 89. Pannirandam Chettiar or Uthama Chettiar. 90. Parkavakulam (including Surithimar, Nathamar, Malayamar, Moopanar and Nainar). 91. Perike (including Perike Balija). 92. Perumkollar (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District). 93. Podikara Vellalar. 94. Pooluva Gounder. 95. Poraya. 96. Pulavar (in Coimbatore and Erode Districts). 97. Pulluvar or Pooluvar. 98. Pusala. 99. Reddy (Ganjam) 100. Sadhu Chetty (including Telugu Chetty, Twenty four Manal Telugu Chetty) 101. Sakkaravar or Kavathi (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District) 102. Salivagana. 103. Saliyar, Padmasaliyar, Pattusaliyar, Pattariyar and Adhaviyar. 104. Savalakkarar. 105. Senaithalaivar, Senaikudiyar and Illaivaniar. 105A.Serakular Vellalar 106. Sourashtra (Patnulkarar) 107. Sozhiavellalar (including Sozha Vellalar, Vetrilaikarar, Kodikalkarar and Keeraikarar) 108. Srisayar. 109. Sundaram Chetty. 110. Thogatta Veerakshatriya 111. Tholkollar (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District) 112. Tholuva Naicker and Vetalakara Naicker. . 113. Omitted. 114. Thoriyar. 115. Ukkirakula Kshatriya Naicker. 116. Uppara, Uppillia and Sagara 117. Urali Gounder (except Tiruchirappali, Karur, Perambalur and Pudukottai Districts) and Orudaya Gounder

or Oorudaya Gounder (in Madurai, Theni, Dindigul, Coimbatore, Erode, Tiruchirapalli, Karur, Perambalur, Pudukottai, Salem and Namakkal Districts).

118. Urikkara Nayakkar. 118A.Virakudi Vellala 119. Vallambar. 119A.Vallanattu Chettiar 120. Valmiki 121. Vaniyar, Vania Chettiar (including Gandla, Ganika, Telikula and Chekkalar) 122. Veduvar and vedar (except in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District where

the Community is a Scheduled Caste),

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123. Veerasaiva (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District). 124. Velar. 125. Vellan Chettiar. 126. Veluthodathur Nair (in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District) 127. Vokkaligar (including Vakkaligar, Okkaligar, Kappiliyar, Kappiliya, Okkaliga Gowda, Okkaliya Gowda,

Okkaliya Gowder, Okkaliya Gowda). 128. Wynad Chetty (The Nilgiris District) 129. Yadhava (including Idaiyar, Telugu Speaking Idaiyar Known as Vaduga Ayar or Vaduga Idaiyar or Golla

and Asthanthra Golla). 130. Yavana 131. Yerukula 131A. Converts to Christianity from any Hindu Backward Classes Community or Most Backward Classes

Community (except the converts to Christianity from Meenavar, Parvatharajakulam, Pattanavar, Sembadavar, Mukkuvar or Mukayar and Paravar) or Denotified Communities

132. Orphans and destitute Children who have lost their parents “before reaching the age of ten and are destitutes and who have nobody else to take care of them either by law or custom; and also who are admitted into any of the schools or orphanages run by the Government or recognized by the Government.

II.LIST OF BACKWARD CLASSES CHRISTIANS

Omitted

III.LIST OF BACKWARD CLASSES MUSLIMS

1. Ansar 2. Dekkani Muslims 3. Dudekula 4. Labbais including Rowthar and Marakayar (Whether their spoken language is Tamil or Urdu) 5. Mapilla 6. Sheik 7. Syed

IV. LIST OF MOST BACKWARD CLASSES 1. Ambalakkarar. 2. Andipandaram 2A. Arayar (in Kanniyakumari District) 3. Bestha, Siviar. 4. Bhatraju (Other than Kshatriya Raju) 5. Boyar, Oddar. 6. Dasari. 7. Dommara. 8. Eravallar (except in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District where the

community is a Scheduled Tribe). 9. Isaivellalar. 10. Jambuvanodai. 11. Jangam. 12. Jogi. 13. Kongu Chettiar (in Coimbatore and Erode Districts only) 14. Koracha. 15. Kulala (including Kuyavar and Kumbarar). 16. Kunnuvar Mannadi. 17. Kurumba, Kurumba Gounder 18. Kuruhini Chetty. 18A.Latin Catholic Christian Vannar (in Kanniyakumari District) 19. Maruthuvar, Navithar, Mangala, Velakattalavar, Velakatalanair and Pronopakari. 20. Mond Golla. 21. Moundadan Chetty. 22. Mahendra, Medara. 23. Mutlakampatti. 24. Narikoravar. 25. Nokkar

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25A.Panisaivan / Panisivan 26. Vanniyakula Kshatriya (including Vanniyar, Vanniya, Vannia Gounder, Gounder or Kander,Padayachi, Palli

and Agnikula Kshatriya). 27. Paravar (except in Kanniyakumari District and Shenkottah Taluk of Tirunelveli District where the community

is a Scheduled Caste) (including converts to Christianity), 28. Meenavar (Parvatharajakulam, Pattanavar, Sembadavar) (including converts to Christianity). 29. Mukkuvar or Mukayar (including converts to Christianity). 30. Punnan Vettuva Gounder. 31. Pannayar (other than Kathikarar in Kanniyakumari District). 32. Sathatha Srivaishnava (Including Sathani, Chattadi and Chattada Srivaishnava). 33. Sozhia Chetty. 34. Telugupatty Chetty. 35. Thottia Naicker (including Rajakambalam, Gollavar, Sillavar, Thockalavar and Thozhuva Naicker and Erra

Gollar). 36. Thondaman. 36A. Thoraiyar(The Nilgiris) 36B. Thoraiyar (Plains) 37. Valaiyar (including Chettinad Valayars). 38. Vannar (Salavai Thozhilalar) (including Agasa, Madivala, Ekali, Rajakula, Veluthadar and Rajaka) (except in

Kanniyakumari District and Shencottah Taluk of Tirunelveli District where the community is a Scheduled Caste).

39. Vettaikarar. 40. Vettuva Gounder. 41. Yogeeswarar.

V. LIST OF DENOTIFIED COMMUNITIES 1. Attur Kilnad Koravars (Salem, Namakkal, Cuddalore, Villupuram, Ramanathapuram, Sivagangai and

Virudhunagar Districts). 2. Attur Melnad Koravars (Salem and Namakkal District). 3. Appanad Kondayam Kottai Maravar (Sivagangai, Virudhunagar, Ramanathapuram, Madurai, Theni and

Dindigul Districts). 4. Ambalakkarar (Thanjavur, Nagapattinam, Thiruvarur, Tiruchirapalli, Karur, Perambalur and Pudukottai

Districts). 5. Ambalakkarar (Suriyanur, Tiruchirapalli District). 6. Boyas (Tiruchirapalli, Karur, Perambalur, Pudukottai, The Nilgiris, Salem, Namakkal and Dharmapuri

Districts). 7. Battu Turkas. 8. C.K.Koravars (Cuddalore and Villupuram Districts). 9. Chakkala (Sivagangai, Virudhunagar, Ramanathapuram, Thanjavur, Nagapattinam, Thiruvarur, Pudukottai,

Tiruchirapalli, Karur, Perambalur, Madurai, Theni, Dindigul and the Nilgiris Districts). 10. Changyampudi Koravars (Vellore and Tiruvannamalai Districts) 11. Chettinad Valayars (Sivagangai, Virudhunagar and Ramanathapuram Districts) 12. Dombs (Pudukottai, Tiruchirapalli, Karur and Perambalur Districts) 13. Dobba Koravars (Salem and Namakkal Districts) 14. Dommars (Thanjavur, Nagapattinam, Tiruvarur, Pudukottai, Vellore and Tiruvannamalai Districts.) 15. Donga Boya. 16. Donga Ur.Korachas. 17. Devagudi Talayaris. 18. Dobbai Korachas (Tiruchirapalli, Karur, Perambalur and Pudukottai Districts.) 19. Dabi Koravars (Thanjavur, Nagapattinam, Thiruvarur, Tiruchirapalli, Karur, Perambalur, Pudukottai,

Vellore and Tiruvannamalai District. 20. Donga Dasaris (Kancheepuram, Tiruvallur, Tiruchirapalli, Karur, Perambalur, Pudukottai, Chennai, Salem

and Namakkal Districts). 21. Gorrela Dodda Boya. 22. Gudu Dasaris. 23. Gandarvakottai Koravars (Thanjavur, Nagapattinam, Thiruvarur, Tiruchirapalli, Karur, Perambalur,

Pudukottai, Cuddalore and Villupuram Districts). 24. Gandarvakottai Kallars (Thanjavur, Nagapattinam, Thiruvarur and Pudukottai Districts.) 25. Inji Koravars (Thanjavur, Nagapattinam, Thiruvarur, Tiruchirapalli, Karur, Perambalur and Pudukottai

Districts.)

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26. Jogis (Kancheepuram, Tiruvallur, Chennai, Cuddalore, Villupuram, Vellore and Tiruvannamalai Districts) 27. Jambavanodai. 28. Kaladis (Sivagangai, Virudhunagar, Ramanathapuram, Madurai, Theni, Dindigul, Thanjavur,

Nagapattinam, Thiruvarur, Pudukottai, Tiruchirapalli, Karur and Perambalur Districts.) 29. Kal Oddars (Kancheepuram, Tiruvallur, Ramanathapuram, Sivagangai, Virudhunagar, Madurai, Theni,

Dindigul, Pudukottai, Thanjavur, Nagapattinam, Tiruvarur, Tiruchirapalli, Karur, Perambalur, Tirunelveli, Thoothukudi, Salem and Namakkal Districts.)

30. Koravars (Kancheepuram, Tiruvallur, Ramanathapuram, Sivagangai, Virudhunagar, Pudukottai, Thanjavur, Nagapattinam, Thiruvarur, Tiruchirapalli, Karur, Perambalur, Tirunelveli, Thoothukudi, Chennai, Madurai, Theni, Dindigul and the Nilgiris Districts)

31. Kalinji Dabikoravars (Thanjavur, Nagapattinam, Thiruvarur and Pudukottai Districts.) 32. Kootappal Kallars (Tiruchirapalli, Karur, Perambalur and Pudukottai District) 33. Kala Koravars (Thanjavur, Nagapattinam, Thiruvarur, Tiruchirapalli, Karur, Perambalur and Pudukottai

District) 34. Kalavathia Boyas. 35. Kepmaris (Kancheepuram, Tiruvallur, Pudukottai, Tiruchirapalli, Karur and Perambalur Districts.) 36. Maravars (Thanjavur, Nagapattinam, Thiruvarur, Pudukottai, Ramanathapuram, Sivagangai, Virudhunagar,

Tirunelveli and Thoothukudi Districts) 37. Monda Koravars 38. Monda Golla (Salem and Namakkal Districts.) 39. Mutlakampatti (Tiruchirapalli, Karur, Perambalur and Pudukottai Districts) 40. Nokkars (Tiruchirapalli, Karur, Perambalur and Pudukottai Districts.) 41. Nellorepet Oddars (Vellore and Tiruvannamalai Districts.) 42. Oddars (Thanjavur, Nagapattinam, Thiruvarur, Tiruchirapalli, Karur, Perambalur, Pudukottai, Madurai,

Theni and Dindigul Districts) 43. Pedda Boyas (Tiruchirapalli, Karur, Perambalur and Pudukottai Districts.) 44. Ponnai Koravars (Vellore and Thiruvannamalai Districts.) 45. Piramalai Kallars (Sivagangai, Virudhunagar, Ramanathapuram, Madurai, Theni, Dindigul, Pudukottai,

Thanjavur, Nagapattinam and Thiruvarur Districts) 46. Peria Suriyur Kallars (Tiruchirapalli, Karur, Perambalur and Pudukottai Districts.) 47. Padayachi (Vellayar Kuppam in Cuddalore District, Tenore in Tiruchirapalli District) 48. Punnan Vettuva Gounder (Tiruchirapalli, Karur, Perambalur and Pudukottai Districts.) 49. Servai (Tiruchirapalli, Karur, Perambalur and Pudukottai Districts) 50. Salem Melnad Koravars (Madurai, Theni, Dindigul, Coimbatore, Erode, Pudukottai, Tiruchirapalli, Karur,

Perambalur, Salem, Namakkal, Vellore and Tiruvannamalai Districts.) 51. Salem Uppu Koravars (Salem and Namakkal Districts.) 52. Sakkaraithamadai Koravars (Vellore and Tiruvannamalai Districts.) 53. Saranga Palli Koravars. 54. Sooramari Oddars (Salem and Namakkal Districts) 55. Sembanad Maravars (Sivagangai, Virudhunagar and Ramanathapuram Districts) 56. Thalli Koravars (Salem and Namakkal Districts.) 57. Thelungapatti Chettis (Tiruchirapalli , Karur, Perambalur and Pudukottai Districts.) 58. Thottia Naickers (Sivagangai, Virudhunagar, Ramanathapuram, Kancheepuram, Tiruvallur, Thanjavur,

Nagapattinam, Thiruvarur, Tiruchirapalli, Karur, Perambalur, Pudukottai, Tirunelveli, Thoothukudi, Salem, Namakkal, Vellore, Tiruvannamalai, Coimbatore and Erode Districts.)

59. Thogamalai Koravars or Kapmaris (Tiruchirapalli, Karur, Perambalur and Pudukottai Districts.) 60. Uppukoravars or Settipalli Koravars (Thanjavur, Nagapattinam, Thiruvarur, Pudukottai, Madurai, Theni,

Dindigul, Vellore and Tiruvannamalai District). 61. Urali Gounders (Tiruchirapalli, Kaur, Perambalur and Pudukottai Districts. 62. Wayalpad or Nawalpeta Korachas. 63. Vaduvarpatti Koravars (Madurai, Theni, Dindigul, Ramanathapuram, Sivagangai, Virudhunagar,

Tirunelveli, Thoothukudi, Tiruchirapalli, Karur, Perambalur and Pudukottai Districts. ) 64. Valayars (Madurai, Theni, Dindigul, Tiruchirapalli, Karur, perambalur, Pudukottai, Erode and Coimbatore

Districts.) 65. Vettaikarar (Thanjavur, Nagapattinam, Thiruvarur and Pudukottai Districts.) 66. Vetta Koravars (Salem and Namakkal Districts.) 67. Varaganeri Koravars (Tiruchirapalli, Karur, Perambalur and Pudukottai Districts.) 68. Vettuva Gounder (Tiruchirapalli, Karur, Perambalur and Pudukottai Districts.)

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THE SCHEDULE (SCHEDULED CASTES) TAMIL NADU 1. Adi-Andhra 2. Adi-Dravida 3. Adi-Karnataka 4. Ajila 5. Arunthathiyar 6. Ayyanavar (in Kanyakumari District and

Shenkottah taluk of Tirunelveli District) 7. Baira 8. Bakuda 9. Bandi 10. Bellara 11. Bharatar (in Kanyakumati District and

Shenkottah taluk of Tirunelveli District) 12. Chakkiliyan 13. Chalavadi 14. Chamar, Muchi 15. Chandala 16. Cheruman 17. Devendrakulathan 18. Dom, Dombara, Paidi, Pano 19. Domban 20. Godagali 21. Godda 22. Gosangi 23. Holeya 24. Jaggali 25. Jambuvulu 26. Kadaiyan 27. Kakkalan (in Kanyakumari District and Shenkottah taluk of Tirunelveli District).

28. Kalladi 29. Kanakkan, Padanna (in the Nilgiris District) 30. Katimpalan 31. Kavara (in Kanyakumati District and Shenkottah taluk of Tirunelveli District). 32. Koliyan 33. Koosa 34. Kootan, Koodan (in Kanyakumari District and Shenkottah taluk of Tirunelveli District). 35. Kudumban 36. Kuravan, Sidhanar 37. Madari 38. Madiga 39. Maila. 40. Mala. 41. Mannan (in Kanyakumat'i District and Shenkottah taluk of Tirunelveli District).

42. Mavilan. 43. Moger. 44. Mundala. 45. Nalakeyava. 46. Nayadi 47. Padannan (in Kanyakumati District and Shenkottah taluk of Tirunelveli District) 48. Pagadai. 49. Pallan 50. Palluvan 51. Pambada. 52. Panan (in Kanyakumari District and Shenkottah taluk of Tirunelveli District). 53. Panchama. 54. Pannadi. 55. Panniandi. 56. Paraiyan, Patayan, Sambavar 57. Paravan (in Kanyakumari District and Shenkottai Taluk of Tirunelveli District) 58. Pathiyan (in Kanyakumari District and Shenkottai taluk of Tirunelveli District) 59. Pulayan, Cheramar 60. Puthirai Vannan 61. Raneyar 62. Samagara 63. Samban 64. Sapari 65. Semman. 66. Thandan (in Kanyakumari District and Shenkottai taluk of Tirunelveli District) 67. Thoti. 68. Tiruvalluvar. 69. Vallon 70. Valluvan. 71. Vannan (in Kanyakumari District and Shenkottai Taluk of Tirunelveli District. 72. Vathiliyan. 73. Velan 74. Vetan (in Kanyakumari District and Shenkottai Taluk of Tirunelveli District) 75. Vettiyan. 76. Vettuvan (Kanyakumari District and Shenkottah Taluk of Tirunelveli District.) 77. S.C. Converts to Buddhism.

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THE SCHEDULE ( SCHEDULED TRIBES) TAMIL NADU

1. Adiyan 2. Aranadan 3. Eravallan 4. Irular. 5. Kadar 6. Kammara (excluding Kanniyakumari District and Shenkottah taluk of Tirunelveli District.) 7. Kanikaran, Kanikkar (in Kanniyakumari District and Shenkottah taluk of Tirunelveli District. 8. Kaniyan, Kanyan. 9. Kattunayakan. 10. Kochu Velan. 11. Konda Kapus. 12. Kondareddis. 13. Koraga. 14. Kota (excluding Kanniyakumari District and Shenkottah taluk of Tirunelveli District.) 15. Kudiya, Melakudi. 16. Kurichchan. 17. Kurumbas (in the Nilgiris District) 18. Kurumans. 19. Maha Mal as ar. 20. Malai Arayan. 21. Malai Pandaram 22. Malai Vedan 23. Malakkuravan 24. Malasar 25. Malayali (in Dharmapuri, Vellore, Pudukottai, Salem, Namakkal, Cuddalore, Villupuram, Tiruchirapalli,

Tiruvannamalai, Karur and Perambalur District) 26. Malayakandi. 27. Mannan 28. Mudugar, Muduvan 29. Muthuvan. 30. Pallayan 31. Palliyan 32. Palliyar 33. Paniyan 34. Sholaga 35. Toda (excluding Kaniyakumari District and Shenkottah taluk of Tirunelveli District) 36. Uraly

*****

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A. R. No: (To be filled by Office) DEPARTMENT OF MEDICAL EDUCATION

APPLICATION FOR PARAMEDICAL CERTIFICATE COURSE (EXCEPT E.E.G./E.C.G./E.M.G. COURSE)

ADMISSION 2009 – 2010 SESSION

1. Name in Block letters (initial at the end) …………………………………………….. SPACE FOR

PHOTOGRAPH 2. Address for Communication (TO BE ATTESTED ………………………………………. BY GRADE A/B ………………………………………. OFFICERS OF …..…………………………………... CENTRAL / STATE Pin…………………………………………… GOVERNMENTS) 3. Name of the Parent / Guardian……………………………………… 4. Religion …………………………. 5. Mother Tongue ………………………….. 6. Nationality 7. Sex 8. Date of Birth Indian Other Male Female Date Month Year 1 2 1 2 9. Community 10. Caste Code S.T. S.C. M.B.C./D.N.C. B.C./B.C.M. O.C. 1 2 3 4 5 11. Name of the Caste …………………………………….. 12. Community Certificate Particulars Sl. No. and Date ………………………………………… Issuing Officer’s Designation ………………………………………… Issuing Office …………………………………………

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13. Qualifying Examination 14. Medium of Instruction H.S.E S.S.C.E of I.S.C.E Others Tamil English Others CBSE 1 2 3 4 1 2 3 15. Appearance in which Qualifying Exam. was passed. First Second Third IV and

above 1 2 3 4 16. Particulars of the Qualifying Examination Reg. No: Month & Year

17. Marks in Select Subjects in Qualifying Examination Subjects Maximum

Marks Marks obtained

Biology

Physics

Chemistry

Botany

Zoology

Vocational

18. Weighted total marks for a maximum of 200:

a. Percentage in Biology (X) …………………………… b. Percentage in Physics and Chemistry

taken together (Y) ……………………………. c. Percentage in Botany and Zoology taken

together (Z) ……………………………. Weighted total for a maximum of 200 ……………………………. The Percentages and the weighted total should be accurate to two decimals 19. Native District Code

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20. Civic Status of your native place and School Place. Corporation Municipality Town Ship Town

Panchayat Village Panchayat

Others

Native Place 1 2 3 4 5 6 School Place 1 2 3 4 5 6 21. Occupation of Parent / Guardian Agriculture Industry Business State

Government Central Government

Private

Small Trade

Others

1 2 3 4 5 6 7 8 22. Average Monthly income of parent Below 1001 1001 – 1250 1251 – 2000 2001 – 4000 4001 – 6000 Above 6000 1 2 3 4 5 6 23. School (s) of Study : Month & Year

of Passing Name and Place of School

X Std XI Std XII Std / Equivalent 24.(a) Whether applied for D.M.L.T. Course : 24.(b) Course applied for in Para Medical Certificate}1.…………………………………….. Courses with order of preferences for 3 Courses }2.…………………………………….. 3………………………………………

25 (a) DECLARATION BY THE APPLICANT I ………………………… (Name in full and in Block Letters) Son / Daughter of ………………………..hereby solemnly declare that the information furnished and the statement given in the application, Scrutiny form and the enclosures are true, correct and complete. I further declare that should it be found otherwise, I will be liable to forfeit my seat and / or removed from the rolls of the Institution at whatever stage of study, I may be liable for criminal prosecution. Place: Date: Signature of the Applicant

25 (b) DECLARATION BY THE PARENT / GUARDIAN I ………………………………………(Name in full and in Block Letters) Father / Mother / Guardian of ………………..hereby solemnly declare that I am fully aware of the declaration made by the applicant, my son / Daughter and I declare and bind myself on the same terms contained with the above declaration. The statements and the information given are true, correct and complete. If it is found otherwise, the applicant is liable to forfeit the admission and liable for criminal prosecution. Signature of the Parent/Guardian Place: Date: Note: The Guardian can execute the above declaration only if both parents are not alive.

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A.R.No:

(To be filled by Office) DEPARTMENT OF MEDICAL EDUCATION

SCRUTINY FORM FOR PARAMEDICAL CERTIFICATE COURSES (EXCEPT E.E.G./E.C.G./E.M.G. COURSE)

ADMISSION 2009 – 2010 SESSION 1. Name in Block letters SPACE FOR (initial at the end) …………………………………… PHOTOGRAPH (TOBE ATTESTED 2. Address for Communication (in Block Letters) BY CRADE A / B ……………………………………………… OFFICERS OF ……………………………………………… CENTRAL /STATE ……………………………………………… GOVERNMENTS) Pin………………………. 3. Name of the Parent / Guardian :

4. Sex :

5. Date of Birth & Age :

6. Nationality :

7. Religion :

8. Community & Name of the Caste

OC / BC/BCM / MBC / DNC / SC / ST:

9. Mother Tongue :

10. Native Place – District :

11. +2 Examination Passed in

( Academic Stream) :

1. Name of the Board / Place :

2. Year of Passing :

3. Marks in +2 Exam :

SUBJECT MAXIMUM MARKS MARKS OBTAINED Biology Physics

Chemistry Botany Zoology

Vocational 12. Course applied for : 1. 2. 3.

Signature of the Candidate

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A.R. No.

(To be filled by Office) DEPARTMENT OF MEDICAL EDUCATION APPLICATION FOR DIPLOMA IN MEDICAL LABORATORY TECHNOLOGY

/DIPLOMA IN RADIOLOGICAL TECHNOLOGY (DRDT/DRTT) COURSE ADMISSION 2009 – 2010 SESSION

1. Name in Block letters (initial at the end) …………………………………………….. SPACE FOR

PHOTOGRAPH 2. Address for Communication (in Block Letters) (TO BE ATTESTED ………………………………………. BY GRADE A/B ………………………………………. OFFICERS OF …..…………………………………... CENTRAL / STATE Pin…………………………………………… GOVERNMENTS) 3. Name of the Parent / Guardian……………………………………… 4. Religion …………………………. 5. Mother Tongue ………………………….. 6. Nationality 7. Sex 8. Date of Birth Indian Other Male Female Date Month Year 1 2 1 2 9. Community 10. Caste Code S.T. S.C. M.B.C./D.N.C. B.C./B.C.M. O.C. 1 2 3 4 5 11. Name of the Caste …………………………………….. 12. Community Certificate Particulars Sl. No. and Date ………………………………………… Issuing Officer’s Designation ………………………………………… Issuing Office …………………………………………

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13. Qualifying Examination 14. Medium of Instruction H.S.E S.S.C.E of I.S.C.E Others Tamil English Others CBSE 1 2 3 4 1 2 3 15. Appearance in which Qualifying Exam. was passed. First Second Third IV and

above 1 2 3 4 16. Particulars of the Qualifying Examination

Reg. No: Month & Year

17. Marks in Select Subjects in Qualifying Examination . Subjects Maximum

Marks Marks obtained

Biology

Physics

Chemistry

Botany

Zoology

Vocational

18. Weighted total marks for a maximum of 200: a. Percentage in Biology (X) …………………………… b. Percentage in Physics and Chemistry

taken together (Y) ……………………………. c. Percentage in Botany and Zoology taken

together (Z) ……………………………. Weighted total for a maximum of 200 ……………………………. The Percentages and the weighted total should be accurate to two decimals 19. Native District Code 20. Civic Status of your native place and School Place. Corporation Municipality Town Ship Town

Panchayat Village Panchayat

Others

Native Place 1 2 3 4 5 6 School Place 1 2 3 4 5 6

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21. Occupation of Parent / Guardian Agriculture Industry Business State

Government Central Government

Private

Small Trade

Others

1 2 3 4 5 6 7 8 22. Average Monthly income of parent Below 1001 1001 – 1250 1251 – 2000 2001 – 4000 4001 – 6000 Above 6000 1 2 3 4 5 6 23. School (s) of Study : Month & Year

of Passing Name and Place of School

X Std XI Std XII Std / Equivalent 24.(a) Whether applied for only D.M.L.T. Course : 24.(b) Course applied also for Para Medical Certificate Courses :

25 (a) DECLARATION BY THE APPLICANT I ………………………… (Name in full and in Block Letters) Son / Daughter of ………………………..hereby solemnly declare that the information furnished and the statement given in the application, Scrutiny form and the enclosures are true, correct and complete. I further declare that should it be found otherwise, I will be liable to forfeit my seat and / or removed from the rolls of the Institution at whatever stage of study, I may be liable for criminal prosecution. Place: Date: Signature of the Applicant

25 (b) DECLARATION BY THE PARENT / GUARDIAN I ………………………………………(Name in full and in Block Letters) Father / Mother / Guardian of ………………..hereby solemnly declare that I am fully aware of the declaration made by the applicant, my son / Daughter and I declare and bind myself on the same terms contained with the above declaration. The statements and the information given are true, correct and complete. If it is found otherwise, the applicant is liable to forfeit the admission and liable for criminal prosecution. Signature of the Parent/Guardian Place: Date: Note: The Guardian can execute the above declaration only if both parents are not alive.

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A.R.No:

(To be filled by Office) DEPARTMENT OF MEDICAL EDUCATION

SCRUTINY FORM FOR DIPLOMA IN MEDICAL LABORATORY TECHNOLOGY/ DIPLOMA IN RADIOLOGICAL TECHNOLOGY

(DRDT/DRTT) COURSE ADMISSION 2009 – 2010 SESSION 1. Name in Block letters SPACE FOR (initial at the end) …………………………………… PHOTOGRAPH (TOBE ATTESTED 2. Address for Communication (in Block Letters) BY CRADE A / B ……………………………………………… OFFICERS OF ……………………………………………… CENTRAL /STATE ……………………………………………… GOVERNMENTS) Pin………………………. 3. Name of the Parent / Guardian :

4. Sex :

5. Date of Birth & Age :

6. Nationality :

7. Religion :

8. Community & Name of the Caste

OC / BC/BCM / MBC / DNC / SC / ST :

9. Mother Tongue :

10. Native Place – District :

11. +2 Examination Passed in ( Academic / Vocational Stream) :

a. Name of the Board / Place :

b. Year of Passing :

c. Marks in Select Science Subjects in the +2 Exam:- SUBJECT MAXIMUM MARKS MARKS OBTAINED

BIOLOGY PHYSICS CHEMISTRY BOTANY ZOOLOGY VOCATIONAL 12. Course applied for :

Signature of the Candidate

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A.R. No.

(To be filled by Office) DEPARTMENT OF MEDICAL EDUCATION

APPLICATION FOR DIPLOMA IN REHABILITATION THERAPY COURSE (2 ½ YEARS)

ADMISSION 2009 – 2010 SESSION

1. Name in Block letters (initial at the end) …………………………………………….. SPACE FOR

PHOTOGRAPH 2. Address for Communication (in Block Letters) (TO BE ATTESTED ………………………………………. BY GRADE A/B ………………………………………. OFFICERS OF …..…………………………………... CENTRAL / STATE Pin…………………………………………… GOVERNMENTS) 3. Name of the Parent / Guardian……………………………………… 4. Religion …………………………. 5. Mother Tongue ………………………….. 6. Nationality 7. Sex 8. Date of Birth Indian Other Male Female Date Month Year 1 2 1 2 9. Community 10. Caste Code S.T. S.C. M.B.C./D.N.C. B.C./B.C.M. O.C. 1 2 3 4 5 11. Name of the Caste …………………………………….. 12. Community Certificate Particulars Sl. No. and Date ………………………………………… Issuing Officer’s Designation ………………………………………… Issuing Office …………………………………………

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13. Qualifying Examination 14. Medium of Instruction H.S.E S.S.C.E of I.S.C.E Others Tamil English Others CBSE 1 2 3 4 1 2 3 15. Appearance in which Qualifying Exam. was passed. First Second Third IV and

above 1 2 3 4 16. Particulars of the Qualifying Examination

Reg. No: Month & Year

17. Marks in Select Subjects in Qualifying Examination . Subjects Maximum

Marks Marks obtained

18. Weighted total marks The Percentages and the weighted total should be accurate to two decimals 19. Native District Code 20. Civic Status of your native place and School Place.

Corporation Municipality Town Ship Town Panchayat

Village Panchayat

Others

Native Place 1 2 3 4 5 6 School Place 1 2 3 4 5 6 21. Occupation of Parent / Guardian Agriculture Industry Business State

Government Central Government

Private

Small Trade

Others

1 2 3 4 5 6 7 8

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22. Average Monthly income of parent Below 1001 1001 – 1250 1251 – 2000 2001 – 4000 4001 – 6000 Above 6000 1 2 3 4 5 6 23. School (s) of Study : Month & Year

of Passing Name and Place of School

X Std XI Std XII Std / Equivalent 24.(a) Whether applied for only D.M.L.T. Course : 24.(b) Course applied also for Para Medical Certificate Courses :

25 (a) DECLARATION BY THE APPLICANT I ………………………… (Name in full and in Block Letters) Son / Daughter of ………………………..hereby solemnly declare that the information furnished and the statement given in the application, Scrutiny form and the enclosures are true, correct and complete. I further declare that should it be found otherwise, I will be liable to forfeit my seat and / or removed from the rolls of the Institution at whatever stage of study, I may be liable for criminal prosecution. Place: Date: Signature of the Applicant

25 (b) DECLARATION BY THE PARENT / GUARDIAN I ………………………………………(Name in full and in Block Letters) Father / Mother / Guardian of ………………..hereby solemnly declare that I am fully aware of the declaration made by the applicant, my son / Daughter and I declare and bind myself on the same terms contained with the above declaration. The statements and the information given are true, correct and complete. If it is found otherwise, the applicant is liable to forfeit the admission and liable for criminal prosecution. Signature of the Parent/Guardian Place: Date: Note: The Guardian can execute the above declaration only if both parents are not alive.

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A.R.No:

(To be filled by Office) DEPARTMENT OF MEDICAL EDUCATION

SCRUTINY FORM FOR DIPLOMA IN REHABILITATION THERAPY COURSE (2 ½ YEARS)

ADMISSION 2009 – 2010 SESSION 1. Name in Block letters SPACE FOR (initial at the end) …………………………………… PHOTOGRAPH (TOBE ATTESTED 2. Address for Communication (in Block Letters) BY CRADE A / B ……………………………………………… OFFICERS OF ……………………………………………… CENTRAL /STATE ……………………………………………… GOVERNMENTS) Pin………………………. 3. Name of the Parent / Guardian :

4. Sex :

5. Date of Birth & Age :

6. Nationality :

7. Religion :

8. Community & Name of the Caste

OC / BC/BCM / MBC / DNC / SC / ST :

9. Mother Tongue :

10. Native Place – District :

11. +2 Examination Passed in ( Academic / Vocational Stream) :

a. Name of the Board / Place :

b. Year of Passing :

c. Marks in Select Science Subjects in the +2 Exam:- SUBJECT MAXIMUM MARKS MARKS OBTAINED

BIOLOGY PHYSICS CHEMISTRY BOTANY ZOOLOGY VOCATIONAL 12. Course applied for :

Signature of the Candidate

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A.R. No.

(To be filled by Office) DEPARTMENT OF MEDICAL EDUCATION

APPLICATION FOR PARA MEDICAL CERTIFICATE COURSE (E.E.G./E.C.G./E.M.G. COURSE- ONE YEAR DURATION)

ADMISSION 2009 – 2010 SESSION

1. Name in Block letters (initial at the end) …………………………………………….. SPACE FOR

PHOTOGRAPH 2. Address for Communication (in Block Letters) (TO BE ATTESTED ………………………………………. BY GRADE A/B ………………………………………. OFFICERS OF …..…………………………………... CENTRAL / STATE Pin…………………………………………… GOVERNMENTS) 3. Name of the Parent / Guardian……………………………………… 4. Religion …………………………. 5. Mother Tongue ………………………….. 6. Nationality 7. Sex 8. Date of Birth Indian Other Male Female Date Month Year 1 2 1 2 9. Community 10. Caste Code S.T. S.C. M.B.C./D.N.C. B.C./B.C.M. O.C. 1 2 3 4 5 11. Name of the Caste …………………………………….. 12. Community Certificate Particulars Sl. No. and Date ………………………………………… Issuing Officer’s Designation ………………………………………… Issuing Office …………………………………………

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13. Qualifying Examination 14. Medium of Instruction H.S.E S.S.C.E of I.S.C.E Others Tamil English Others CBSE 1 2 3 4 1 2 3 15. Appearance in which Qualifying Exam. was passed. First Second Third IV and

above 1 2 3 4 16. Particulars of the Qualifying Examination

Reg. No: Month & Year

17. Marks in Select Subjects in Qualifying Examination . Subjects Maximum

Marks Marks obtained

Biology

Physics

Chemistry

Botany

Zoology

Vocational

18. Weighted total marks for a maximum of 200: a. Percentage in Biology (X) …………………………… b. Percentage in Physics and Chemistry

taken together (Y) ……………………………. c. Percentage in Botany and Zoology taken

together (Z) ……………………………. Weighted total for a maximum of 200 ……………………………. The Percentages and the weighted total should be accurate to two decimals 19. Native District Code

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20. Civic Status of your native place and School Place. Corporation Municipality Town Ship Town

Panchayat Village Panchayat

Others

Native Place 1 2 3 4 5 6 School Place 1 2 3 4 5 6 21. Occupation of Parent / Guardian Agriculture Industry Business State

Government Central Government

Private

Small Trade

Others

1 2 3 4 5 6 7 8 22. Average Monthly income of parent Below 1001 1001 – 1250 1251 – 2000 2001 – 4000 4001 – 6000 Above 6000 1 2 3 4 5 6 23. School (s) of Study : Month & Year

of Passing Name and Place of School

X Std XI Std XII Std / Equivalent 24.(a) Whether applied for only D.M.L.T. Course : 24.(b) Course applied also for Para Medical Certificate Courses :

25 (a) DECLARATION BY THE APPLICANT I ………………………… (Name in full and in Block Letters) Son / Daughter of ………………………..hereby solemnly declare that the information furnished and the statement given in the application, Scrutiny form and the enclosures are true, correct and complete. I further declare that should it be found otherwise, I will be liable to forfeit my seat and / or removed from the rolls of the Institution at whatever stage of study, I may be liable for criminal prosecution. Place: Date: Signature of the Applicant

25 (b) DECLARATION BY THE PARENT / GUARDIAN I ………………………………………(Name in full and in Block Letters) Father / Mother / Guardian of ………………..hereby solemnly declare that I am fully aware of the declaration made by the applicant, my son / Daughter and I declare and bind myself on the same terms contained with the above declaration. The statements and the information given are true, correct and complete. If it is found otherwise, the applicant is liable to forfeit the admission and liable for criminal prosecution. Signature of the Parent/Guardian Place: Date: Note: The Guardian can execute the above declaration only if both parents are not alive.

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A.R.No:

(To be filled by Office) DEPARTMENT OF MEDICAL EDUCATION

SCRUTINY FORM FOR PARA MEDICAL CERTIFICATE COURSE (E.E.G./E.C.G./E.M.G. COURSE- ONE YEAR DURATION)

ADMISSION 2009 – 2010 SESSION 1. Name in Block letters SPACE FOR (initial at the end) …………………………………… PHOTOGRAPH (TOBE ATTESTED 2. Address for Communication (in Block Letters) BY CRADE A / B ……………………………………………… OFFICERS OF ……………………………………………… CENTRAL /STATE ……………………………………………… GOVERNMENTS) Pin………………………. 3. Name of the Parent / Guardian :

4. Sex :

5. Date of Birth & Age :

6. Nationality :

7. Religion :

8. Community & Name of the Caste

OC / BC/BCM / MBC / DNC / SC / ST :

9. Mother Tongue :

10. Native Place – District :

11. +2 Examination Passed in ( Academic / Vocational Stream) :

a. Name of the Board / Place :

b. Year of Passing :

c. Marks in Select Science Subjects in the +2 Exam:- SUBJECT MAXIMUM MARKS MARKS OBTAINED

BIOLOGY PHYSICS CHEMISTRY BOTANY ZOOLOGY VOCATIONAL 12. Course applied for :

Signature of the Candidate


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