Application Form for Nursing Registration

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  5. Application Form for Permanent Nursing Registration
 
 
Applicant's Details
Registration Type*
 
Candidate Details
 
Title
Applicant's Name
First Name* Middle Name Last Name
Mother Name*
Father Name*
Date Of Birth *  (dd/mm/yyyy)
Gender  
Religion
Address
Address (Only Fill Address. Don't enter District/State/Country/Pin Code within Address field.)

District State Country
PinCode Mobile No. EMail Id
Aadhaar No.
Course Details
 
Course Name
Nursing College
University
Examining Body
Final Year Roll No
Month & Year of Joining
Month Year
Month & Year of Passing  
Month Year
Completed On
Day Month Year
Training Hospital-3 (if applicable)
Hospital Name  Hospital
District
Joining Date
Day Month Year
Completed On
Day Month Year
     
Instructions
1. Following documents should be uploaded at the time of filling Application Form for Nursing Registration at U.P. Nurses & Midwives Council:
1. HIGH SCHOOL CERITIFICATE � DATE OF BIRTH PROOF (ORIGINAL COLORED SCANNED IMAGE - jpg Format)
2. INTERMEDIATE CERITIFICATE (ORIGINAL COLORED SCANNED IMAGE - jpg Format)
3. FINAL YEAR MARKSHEETS (ORIGINAL COLORED SCANNED IMAGE - jpg Format)
4. COURSE COMPLETION CERTIFICATE (ORIGINAL COLORED SCANNED IMAGE - jpg Format)
5. DIPLOMA/DEGREE/PROVISIONAL CERTIFICATE (ORIGINAL COLORED SCANNED IMAGE - jpg Format)
6. AADHAR CARD (ORIGINAL COLORED SCANNED IMAGE - jpg Format)
7. REGISTRATION CERTIFICATE - OTHER COUNCIL (In case Registered by Other State Council) (ORIGINAL COLORED SCANNED IMAGE - jpg Format)

Please check whether all entries made and uploadings are correct or not through the <Preview Final Submission>, before making the payment.
No Futher updates within Applicant's Details, Uploaded Photographs & Documents will be permissible after the Payment process.

Do not make repayment again and again. In case of failure/discripany, please make the next payment after having a confirmation from the office to avoid extra payments.
For any payment related query, please mail to Email : upnursescouncil@upsmfac.org with your Reference No., Name & Mobile No.
2. U.P. Nurses & Midwives Council has the right to cancel the certificate, if any information is found to be incorrect or fake.
3. If any discripancy is found, please contact below:
U.P. Nurses & Midwives Council
5, Sarvpalli
Mall Avenue Road,
Lucknow - 226001 (U.P.)
India
Phone Contact No.(s): (0522) 2238846, 3302100 (Ext.: 207-210)
Email : upnursescouncil@upsmfac.org
4. Online Payment related query EMail: supportaccount@upsmfac.org