Admission FormChandidas Institute of Nursing & Paramedical SciencesApplication Form For AdmissionPersonal Details First Name Middle Name Last Name Date of Birth Your Last Education Qualification Father's Name Mother's Name Contact Details Area/Street Address District Village / City Select State Name Select a StateWest BengalJharkhandAndhra PradeshArunachal PradeshAssamBiharChhattisgarhGoaGujaratHaryanaHimachal PradeshKarnatakaKeralaMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhand PIN No Mobile No. Email Guardian Contact No. Course Details Name of Course Select a CourseMedical Laboratory TechnologyOperation Theatre TechnologyIntensive Care Unit TechnologyEmergency Medical TechnologyRadiology and Imaging TechnologyNursing AssistantDialysis TechnologyPhysiotherapyOptometryX-Ray TechnologyCardiac Care TechnologyAnaesthesia TechnologyBlood Bank TechnologyECG Technology Course Duration Select Course DurationTwo Year Diploma(Six Month Internship)One and Half Year Diploma(Six Month Internship)One-Year Diploma(Six Month Internship)One-Year Certificate(Six Month Internship) Terms and Conditions I agree to the Terms and Conditions Attachments Upload Your Identity Proof Upload Your Last Educational Qualification Documents Your Passport Size Photo with Signature Signatures Applicant Signature Guardian Signature Date DD / MM / YYYY Submit Application