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Dian Nursing Council, New Delhi, Rajasthan Govt. & Rajasthan University of Health Sciences, Jaipur) 1. Name of the Candidate (Leave one box empty between first Name and Surname 2. Father s / Husband s Name / Mother s Name (Strick out whichever is not applicable) 3. Date of Birth 4. Nationality : 5. Category: 6. Address for correspondence (Do not give Post Box No. Leave a blank box between each unit of address like. House No. Street Name, P. O .etc. 7. City: 8. State 9. Ph.

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