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R passport size APPLICATION FOR RENEWAL OF NURSING REGISTRATION Write with Ball Pen in Capital Letters only. Write complete address with District, Pin-code mandatory. Applicant should sign in full, clearly within the Box Provided. Incomplete form will be rejected. Application form should fill up by the applicant's own handwriting. 1. Name in Full: Miss Mrs. Sr. Mr. Others (3X4 cm2 ) photo Please tick ( ) as appropriate. 2. Father's / Husband's Name: 3. Date of Bi.

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