Dr. NT R UNIVERSITY OF HEALTH SCIENCES, ANDHRA PRADESH,
VIJAYAWADA- 520 008

APPLICATION FOR ISSUE Of PERMANENT DEGREE CERTIFICATE IN ADVANCE OF THE
FORTHCOMING ANNUAL CONVOCATION
NO FORMAT OTHER THAN THIS SHALL BE USED. PLEASE READ THE INSTRUCTIONS AVAILABLE AT COLLEGE OFFICE & UNIVERSITY WEBSITE. BEFORE FILLING UP AND SUBMIT TO THE UNIVERSITY THROUGH THE CONCERNED PRINCIPAL, BY THOSE CANDIDATES WHO HAVE PASSED MBBS EXAMINATION AND AFTER COMPLETION OF INTERNSHIP BETWEEN THE LAST AND FORTHCOMING ANNUAL CONVOCATION ONLY.

1. Name of the Candidate. (As in Intermediate Certificate)
2. Name of the Father I Mother
3. Details of Study :
a.) MBBS Passed in (Month & Year)
b.) Division
c.) College where studied and Passed: ---------------
d.) Registered No. I Hall Ticket No.
4. Details of Fee Paid;_
a.) Amount : Rs. --------- b.) DO I Pay Order I Dr. NTR UHS Chall an No.:
c.) Name of the Bank: ------------- Date :
5. Details of Internship:
6. Details of Registration done with state MCI :
a.) Date From : _______ To: _______ a.) Temporarary Registration Number :
b.) Name & Place of the Hospitals : ______ b.) Date & Place of Registration:
NAME & ADDRESS:
Please affix here your
latest passport size
photograph
(Colour only)
DO NOT STAPLE
OR PIN THE PHOTO
PIN :
Left Hand Thumb Impression of the Candidate Signatu re of Applicant

IMPORTANT NOTE :
Please go through the INSTRUCTIONS I GUIDELINES before filling up the application, which is
available with your college office or you can download the INSTRUCTIONS from NTRUHS Website
at : http: 1/ntruhs.ap.nic.in
Enclose the following certificates (attested copies) in order of prefernence.
1. Intermediate Certificate
2. Copies of Marks Memos of all years.
3. Provisional Certificate.
4. Internship Certificate.
5. Temporary Registration Certificate.
6. Demand Draft Rs. 2,000/- in favour of Regisrar Dr. NTR UHS Payable at Vijayawada.
7. If Transferred from one College to another college for Internship, G.O copy to be Enclosed. -------------------------
FOR THE USE OF PRINCIPAL'S OFFICE ONLY
Certified that the details furnished above by Dr. ------------------------------are
verified from the relevant records and are found correct. The applicant has no dues to this College.
Hence, there is no objection for issue of MBBS Degree to him I her.
Station : -----------------------------
Date : ----------------------------
(Signature of the Principal with Office Seal)
(NO FACSIMILE TO BE USED)
FOR THE USE OF Dr. NTR UHS EXAMINATION WING
1.) TR Page No.------------
2.) Degree Certificate St. No. ------------------
3.) SI.No & Page No.of the Degree Issue Register (IN ADVANCE OF) --------------------------Submitted:
All the details have been verified. DO I PO has been sent to the Finance Wing. Hence, the Permanent
Degree Certificate may be issued.
Jr. Asst Sr.Asst Supdt Asst. Registrar(Exams) Deputy Registrar (Exams)