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Government of Karnataka
GADAG INSTITUTE OF MEDICAL SCIENCES, GADAG Mallasamudra, Gadag– 582103
E-mail ID: [email protected] web: www.karnataka.gov.in/gimsgadag
BROCHURE FOR 2017-18
MBBS ADMISSION
Admission officer: [KEA] Dr.PRATEEK KHONA Phone:9916575877 . Dr.Roopadevi
Phone:8951127808
Admission officer [AIQ Seats] Dr. ANAND HUGAR [Warden] Mobile No:8971282391
Principal office:-08372-297273- 297274
www.Karnataka.gov.in/gimsgadag
College fee to be paid at Corporation Bank, Puttaraj Statue circle, Gadag
Account name:THE PRINCIPAL GIMS GADAG
Account number:006200101035910
IFSC code:CORP0000062
IMPORTANT
1. No forms/proforma will be issued at GIMS office as they are made available in GIMS website.
2. NO MANAGEMENT SEATS AVALIABLE IN THIS GOVERNMENT COLLEGE.
3. The mobile contact number that will be furnished to the Principal office the same will be
submitted to the University. During examination time, the OTP from University will be sent to
the same number for filing the examination forms. Therefore, STUDENTS ARE HEREBY
INSTRUCTED TO RETAIN THE SAME MOBILE NUMBER THROUGH OUT THE
COURSE.
4. Please call in office Timings Holiday list and Map for College Enclosed.
5. A Induction programme for all I mbbs students will be had in first week of August 2017. Kindly
contact Dr.Roopa B (Ph.9742118485) and Dr.Chandrashekhar (Ph.9164500454)
6. Bonds are available at Cooperative Banks, Mulgund Naka, Gadag or elsewhere
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DOCUMENTS TO BE PRODUCED AT ADMISSION
SL
NO
PARTICULARS
1 Requisition letter addressed to the Principal, GIMS Gadag requesting for MBBS admission
(proforma enclosed)
2 Form-I and Form-II (proforma enclosed )
3 CET allotment order
4 CET marks card
5 Admit card/ counseling letter results sheet (for All India Quota Students)
6 Original challan for having paid college fee
7 10th marks card / 10
th passing certificate
8 12th marks card / 12
th passing certificate
9 Students claiming reservation under Hyderabad- Karnataka region (article- 371J) shall submit
Eligibility certificate
10 Transfer certificate
11 Study certificate from the Institute last attended
12 Character and conduct certificates from the Institute last attended
13 Caste certificate
14 Income certificate
15 Domicile certificate (other than Karnataka students ).
16 Eligibility certificate from RGUHS (for students other than Karnataka PU board)
17 Migration certificate from the University last attended (if Applicable)
18 Migration certificate from the board if passed 12th standard from board other than Karnataka PU
board
19 Physical fitness certificate (Medical certificate) from GIMS teaching Hospital /District surgeon
20 Regional Language and English translated caste certificates from eligible CET students to be
submitted during admission by SC/ST/CAT-1,2a,2b,3a,and 3b students who scored less than 50%
and more than 40% marks in 10+2 (PCB) examination required for submission to MCI, New Delhi.
21 Regional Language and English translated caste certificates from the eligible CET/NEET students
to be submitted during admission by SC/ST/CAT-1,2a,2b,3a,&3b students who scored less than
50% and more than 40% marks in entrance examination required for submission to MCI, New
Delhi
22 Annexure –I, Part-I:-Undertaking by the student to be typed in Rs.200/- E-stamp paper and duly
attested by notary (proforma enclosed).
23 Annexure I. Part-II:- Undertaking by parent /guardian-to be typed in Rs.200/- E-stamp paper and
duly attested by notary (proforma enclosed)
24 Undertaking -MBBS degree programme as per RGUHS curriculum- to be typed in Rs.50/- E-stamp
paper and duly attested by a notary (proforma enclosed)
25 Rural service bond by candidates who select MBBS seats in GIMS, Gadag-to be typed in Rs.200/-
E-stamp paper and attested by a notary (proforma enclosed)
26 Four (04) recent color digital passport size photographs. The photographs must indicate clearly the
name of the candidate along with the date of taking the photograph. Candidates must Keep 8-10
identical photographs ready in reserve for further use.
27 2 plastic folders /file with latest photographs affixed on it including name and address of the
candidate. Please provide good quality thick folder of safe keeping of your ORIGINAL certificates
voluntarily deposited with college.
28 5 self addressed Rs.30/- Stamped Envelopes.
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NO.GIMS/ /UGS:______ Office of the Director
Gadag institute of Medical sciences
Gadag
OFFICE MEMORANDUM
Sub: MBBS Phase-I admission through KEA Bangalore-2017 and voluntary deposition of original
certificates /testimonials - reg
Ref: KEA Bangalore online generated admissions order No: ________ dt _______ 2017
Mr./Miss_________________________KEA/CET No._________Rank No: ___________, Category
_______________who has been selected and allotted to Gadag Institute of Medical Sciences, Gadag has
reported and provisionally admitted to MBBS Phase-I on ___________2017 subject to the approval of
concerned authorities. He/she has submitted all relevant original certificates and testimonials to this
college on own will on the condition that admission are subject to approval rules and of MCI, RGUHS ,
Government of Karnataka and Ministry of health and family welfare, Government of India. The said
student and parents have been informed that seat surrender if any will be directly to KEA, Bangalore.
Principal
Gadag Institute of Medical Sciences
Gadag
To: The Candidate.
Candidate Name _________________________
Address and Phone Number___________________
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NO.GIMS/ /UGS:_____ Office of the director
Gadag Institute of Medical Sciences Mallasamudra
Gadag
OFFICE MEMORANDUM
Sub: MBBS Phase-I admission through AIQ-2017 and voluntary deposition of original certificate
/testimonials - reg.
Reg: DGHS-ALL India Quota 2017 Medical Counseling Committee, New Delhi Online generated
provisional seat allotment letter no.__________ dt:__________
Mr./Miss________________ category __________________seat Allotted Category-
_____________Merit/Rank No._______ Roll No.__________ who has been allotted MBBS seat during
first /Second /Third AlQ-2017 counseling to Gadag Institute of Medical Sciences , Gadag has reported
and provisionally admitted to MBBS Phase-I on _____________subject to the approval of concerned
authorities. He/ She has submitted all relevant originals certificates and testimonials to this college on
own will with the condition that MBBS admission are subject to approval and rules of MCI, RGUHS,
Government of Karnataka and Ministry of health and family welfare, Government of India. The said
student and parents have been informed that seat surrender if any will be directly to MCC, AIQ seat
allotting cell of DGHS.
To: The candidate,
Candidate name :______________________
Address and phone number _______________
Parent of candidate shall agree to give correct address and Email id and contact phone numbers of self
Parents address:__________________
Phone number _________________
Principal
Gadag institute of medical sciences
Gadag
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FORM-I
GADAG INSTITUTE OF MEDICAL SCIENCES,GADAG TO BE FILLED BY THE CANDIDATES FOR OFFICE USE
(TO BE FILLED IN BLOCK LETTERS ONLY)
Sl.
NO
PARTICULARS INFORMATION TO BE FILLED
1 Name of the Candidates as per 10th Marks
card.
2 Blood Group
3 Father Name :
Parents permanent Address:
Phone Nos (of Student and parent/Guardian)
And Email Ids (of Students and Parent
guardian)
4 Sex
5 Caste Religion :
Caste :
Category :
6 Nationality
7
Allotment/Bank Details
CET NO: BANK:
AIQ : BANK:
8 Marks Scored in CET/AIQ
(Enclosed Details )
Exam
Passed
Max Marks Marks
Obtained
% of
Marks
CET
AIQ
Qualification Exam
Register No in PCU/12th Class
PUC/12th Class Passed Year Date Month Year
Specify the name of the University / Board
where you have studied PUC / 12th STD.
Total marks scored in optional subject in
PUC / 12th Standard
Max Marks Marks
Obtained
% of Marks
Physics
Chemistry
Biology
Total marks
Marks scored in English subject in all
subject in PUC / 12TH
Standard
Max Marks Marks
Obtained
% of Marks
Total marks scored in all subject in PUC /
12TH
Standard
9 Date of birth (as per 10th marks card) DD/MM/YYYY:
10 Date of admission Date Month Year:
11 Documents Enclosed (yes/no)
Place : Signature of the Candidates :
Date : Signature of the Parent :
Affix recent
photograph
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FORM-II
GADAG INSTITUTE OF MEDICAL SCIENCES, GADAG TO BE FILLED BY THE CANDIDATES FOR OFFICE USE
(TO BE FILLED IN BLOCK LETTERS ONLY) Particulars Information to be filled up
1 Allotment No. CET
AIQ
2 Date of admission
3 Name of the candidate
4 Father name (specify name of the guardian, if father is
not alive)
5 Occupation
6 Permanent address of Parent
7 Correspondence address of Parent
8 Income of the Parent / guardian
9 Place of birth
10 Date of birth
11 Religion caste category (sc/st/other category-please
specify)
12 Native district
13 Karnataka/ non Karnataka
14 Name of the former school/college studied
15 Qualifying exam passed
16 Whether vaccinated
17 College fees paid at the time of admission
18 Bank receipt no.& date :
1. I here with give an undertaking that I will adhere to the rules of good conduct. And will be in general obedient to the
teachers and will not any way disturb the harmony of the college and departments.
2. I will not myself indulge in any union activities or such activities undesirous of a medical student.
3. As the parent, will not allow my child or myself instigate my ward to put a case in courts and will try to amicably settle
all such disputes firstly within college authorities.
4. I will agree voluntarily to deposit all my certificate and testimonials as prescribed by RGUHS for verification and
admission approval.
Full address of parent: Mobile number and Email ID of Parent:
(DO NOT PROVIDE EMAIL ID OFSTUDENT)
Mobile number and Email ID of Candidate:
Place:Gadag Signature of the candidate
Date:
Signature of the parent
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ANNEXURE l – PART l
UNDERTAKING BY THE STUDENT
1. I, ___________________________________________________________ S/o / D/o. of
Mr./Ms.______________________________________________, have carefully read and fully
understood the law prohibiting ragging and the directions of the Supreme Court and the
Central/State Government in this regard.
2. I have received a copy of the MCI Regulations on Curbing the Menace of Ragging in Higher
Educational Institutions, 2009 and read it fully and explained to my ward.
3. I hereby under take that –
I will not indulge in any behavior or act that may come under the definition of ragging
I Will not participate in or abet or propagate ragging in any form,
I Will not hurt anyone physically or psychologically or cause any other harm.
I Will resubmit such a undertaking again yearly to the Principal GIMS and reiterate my
commitment
4. I hereby agree that if I found guilty of any aspect of ragging, I may be punished as per the
provisions of the MCI Regulations mentioned above and/or as per the law in force without any
warning or notice.
Signed this _________ day of _____________________________ month of ______________year
1. Witness (signature & address) Signature:-
Address:__________________________
_________________________________
_________________________________
Mobile Number:
2. Witness (Signature & Address)
SEAL & SIGNATURE OF
THE GOVERNMENT NOTARY
l. Party-Student
ll. Party- Director GIMS Gadag
TO BE TYPED IN RS-200 E-STAMP PAPER
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ANNEXURE l, PART ll
UNDERTAKING BY PARENT/GUARDIAN
1. I _______________________________________________________________ F/O /M/o / G/o
______________________________________________________ aged _____________ years,
Working as __________________________________ ( occupations), Resident of
______________________________________________________________________________
_______________________________________________________________(correspondence
address) have carefully read and fully understood the law prohibiting ragging and the directions
of the Honorable Supreme Court and the Central/State Government in this regard as well as the
MCI Regulations on Curbing the Menace of Ragging in Higher Educational Institutions,2009.
2. I assure you that my son /daughter will not indulge in any act of ragging.
3. I hereby agree that if he/she is found guilty of indulging in ragging, he/she may be punished as
per the provisions of the MCI Regulations mentioned above and/or as per the law in force.
4. I agree to submit such as undertaking yearly to the Principal, GIMS.
Signed this _________ day of _________________________ month of ___________ year
1. Witness (Signature & Address) ( )
Signature & address :
2. Witness (Signature & Address )
SEAL & SIGNATURE OF
THE GOVERNMENT NOTARY
l. Party-Parent/Guardian
II. Party- Direction GIMS Gadag
TO BE TYPED IN RS.200/-E-STAMP PAPER
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UNDERTAKING ABOUT
MBBS DEGREE PROGRAMME AS PER RGUHS
CURRICULUM
I, ___________________________________________________________ Son / Daughter of
______________________________________ (herein after called the Natural Guardian of the Student )
hereby give an undertaking that on admission to I MBBS at Gadag Institute of Medical Sciences, Gadag ,
during the year 2017-18 have read the rule No.11 of the ordinance of Governing M.B.B.S Degree
Programme of Rajiv Gandhi University of Health Sciences, Bangalore, vide Notification No.ACA/BOS-
27/97-98, dated: 24.03.1998, and I shall abide / by the RGUHS regulations.
That no student shall be permitted to join Phase-II (Para Clinical & Clinical) Group of subjects
until he / she Passes in the Phase-I (Pre-clinical) subjects for which he / she will be permitted not more
than four chances (Actual Examination) provided four chances are completed within three years from the
date of enrollment. My parent also give undertaking that my parent shall visit college every 6 monthly to
enquire my progress w.r.t attendance and assessments.
Signature of the student with full
Address and phone number .
Witness:
1.
2.
Signature of parent
I Party – Candidate
II Party – Director
Rs 50/- E-STAMP
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EXECUTION OF RURAL SERVICE BOND BY CANDIDATES WHO SELECT MBBS SEATS IN
GIMS, GADAG.
l Mr./Ms._______________________________, S/o. / D/o._____________________________ a
Candidate with CET / AIQ – 2017 Admission Ticket No. ______________________ residing at
____________________________________________________________ have been allotted an MBBS
seat on ____________________ in _________________________________________
_________________________________________________ vide admission order number ___________
Dated ___________________ and do hereby undertake on my own volition as follows.
In accordance with the Amendment to rule 1 1 of the Karnataka Selection of Candidates for
Admission to Government seats in Professional Educational Institutions Rules, 2006, vide Government
Notification- 1. No.HFW 79 RGU 2011 dated 17.07.2012, I am prepared on completion of the course to
serve in any Primary Health Center or Primary Health Unit situated in Rural Areas in the State of
Karnataka for a minimum period of ONE year, allotted to me, failing which I render myself liable to pay
a penalty of rupees ten lakhs to Government of Karnataka and the institute as per rules of the government
in force.
What is stated above is true and correct as per present rules in forces,as decided by the
Government of Karnataka and I hereby undertake to act accordingly. I also understand that if such rules
are changed or notified by Government I and my ward are duty bound to follow such rules also. I have
read and understood the above statement made by my son/daughter on oath-& I have my un-equivocal
consent to the same.I also understand that I /my ward will not claim any job in this regard.
1. Signature of the Candidate
2. Signature of the Parent
(Father/Mother)
Date : ___________
Place : ___________
SEAL & SIGNATURE OF
THE GOVERNMENT NOTARY
l. PARTY - Student
II. Party_ Government of Karnataka
TO BE TYPED IN RS.200/- E-STAMP PAPER
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REQUISITION LETTER FOR CET STUDENTS
To Date:
The Principal,
GIMS, Gadag.
Sir,
Sub: - Request for admission to I year MBBS course at GIMS, Gadag allotted through
Karnataka Common Entrance Test – reg.
Reg:- Letter No. ___________ dated: _____________ of Executive Director KEA, Bangalore.
-------------------
As per the letter cited under reference, I, Mr / Ms. ________________________________
S/o, D/o. ____________________________, bearing Admission Order No. _______________________,
CET No. _____________ Rank No._____________ who belong to ____________ category have been
allotted MBBS seat at Gadag Institute of Medical Sciences, Gadag under ____________ category.
I am herewith voluntarily enclosing the original fee challan for having paid college fees along
with necessary original documents. For due verification by RGUHS. Hence, I request your kind self to
admit me in your institute for I MBBS course on my request and risk and I am aware that my admission is
subject to the approval of the concerned competent authorities, for which GIMS, Gadag will not be held
responsible for any consequences / objections those may arise in future with regard to my admission. Also
the address provided to GIMS, Along With Phone Numbers, E-mail id are permanent as on date, and any
changes will be intimated to GIMS.
Yours faithfully,
(Signature of the candidate)
(Signature of the parent / Guardian)
Place: Gadag
Date:
Permanent address of Parent
With E-mail id or phone numbers
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REQUISITION LETTER FOR AIQ STUDENTS
To Date:
The Principal,
GIMS, Gadag.
Sir,
Sub:- Request for admission to I Year MBBS course at GIMS, Gadag allotted through All India Quota
-reg.
Sub:-Provisional Allotment Letter of AIQ-UG Medical Online Allotment Process ________
Counselling- 2017 Dated:_________
-----------
As per the letter cited under reference, I, Ms. / Mr. __________________________________ S/o,
D/o._____________________________, bearing Admission Order No. ________________, CET
No.________________ Rank No.____________ who belong to ___________ category have been allotted
MBBS seat at Gadag Institute of Medical Sciences, Gadag under __________ category.
I am herewith voluntarily enclosing the original fee challan for having paid college fees along
with necessary original documents.Hence, I request your kind self to admit me in your institute for I
MBBS course on my request and risk and I am aware that my admission is subject to the approval of the
concerned competent authorities.GIMS Gadag will not be held responsible for any consequences /
objection those may arise in future with regard to my admission. Address provided by me, phone
numbers, E-mail id of parent are accurate, permanent as on date and charges if will be intimated to GIMS.
Yours faithfully,
(Signature of the candidate)
(Signature of the parent / Guardian)
Place: Gadag
Permanent Adress of parent with
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Phone number and E-mail id
INFORMATION TO BE FILLED UP BY KARNATAKA CET / ALL INDIA
QUOTA STUDENTS
(STRIKE WHICHEVER IS NOT APPLICABLE)
1.Mr. / Ms. ________________________________ have been selected to MBBS Course Through
KARNATAKA CET-2016 / ALL INDIA QUOTA and allotted to GIMS. Gadag. I am herewith
submitting a requisition letter seeking for admission. My admission details are as follows:-
CET / AIQ Allotment No. and Date:
a. CET / AIQ Rank No.:
b. Category :
c. Allotted Category :
d. Last Date for admission :
LIST OF DOCUMENTS SUBMITTED BY Mr. / Ms……………………………………………………………..
SL.N
O
PARTICULARS
SUBMIT
TED
NOT
SUBMITT
ED
NOT
APPLICABLE
1 Requisition letter addressed to the Principal, GIMS , Gadag
requesting for MBBS Admission
2 Form & Form-II
3 CET allotment order
4 CET marks card
5 Admit card / counseling letter / NEET results sheet (for AIQ
Students)
6 Original challan for having paid college fee
7 10th
marks card / 10th
passing certificate
8 12th
marks card / 12th
9 Students claiming reservation under Hyderabad-Karnataka region
(article-371J) Shall submit eligibility certificate
10 Transfer certificate
11 Study certificate from the institute last attended
12 Character and conduct certificates from the institute last attended
13 Caste certificate
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Place:Gadag Signature of Candidate
Signature of Parents
14 Income certificate
15 Domicile certificate
16 Eligibility certificate from RGUHS (for students other than Karnataka
PU board)
17 Migration certificate from the university last attended (if applicable)
18 Migration certificate from the board if passed 12th standard from the
board other than Karnataka PU board
19 Physical fitness certificate (Medical certificate from GIMS teaching
hospital)
20 Regional language and English translated caste certificates to be
submitted by SC/ST/CAT-l, 2a,2b,3a & 3b students who are eligible
for admission with less than 50% and more than 40% marks in 10+2
(PCB) Examination Required For Submission To MCI.
21 Regional language and English translated caste certificates to be
submitted by SC/ST/CAT-l, 2a,2b,3a & 3b students who are eligible
for admission with less than 50% and more than 40% marks in
entrance examination required for submission to MCI
.22 Annexure I, part II:- undertaking by the candidate/ student – to be
typed in Rs.200/- E-stamp paper.
23 Annexure I, part II:- undertaking by the parent/ guardian– to be typed
in Rs.200/- E-stamp paper.
24 Undertaking. MBBS degree programme as per RGUHS curriculum-
to be typed in Rs.50/- E-stamp paper.
25 Execution of rural service bond by candidates who select MBBS seats
in GIMS, Gadag- to be typed in Rs.200/- E-stamp paper.
26 Four (04) recent colour digital passport size photographs one single
file with latest photograph affixed on it including name and address of
the candidates.
27 Vehicle Driving related affidavit incase of parents allowing children
to ride vehicle.
28 05 self addressed Rs 30/- stamped Envelopes for Correspondence.
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GENERAL INSTRUCTIONS FOR THE STUDENTS WHO ARE TAKING ADMISSION
FOR
l-MBBS COURSE AT GADAG INSTITUTE OF MEDICAL SCIENCES, GADAG
ALLOTTED THROUGH KARNATAKA CET/ ALL INDIA QUOTA
1. Students must report in principal’s office at GIMS for MBBS admission on or before date
indicated on their selection letter issued by K-CET / NEET AIQ at 10-00 am. If any
student fails to report before last date indicated in the office letter, his / her admission
will stand cancelled and the same will be intimated to concerned authorities.
2. The students are instructed to download all the below mentioned forms and must
be filled in by his / her own handwriting with blue or black point pen neatly and
legibly in English or computer typed in capital letters only, except for signature and
submit the same at the time of admission.
3. One of the parent / guardian must accompany students at the time of admission or
demitting seats as certain documents are to be signed by them.
4. The admission process is likely to make two days.Outstation candidates are
requested to not cause hurry in admission or demitting seats.
5. The admission offered to a candidate will be only provisional. DME & RGUHS are final
authorities.
6. The students are instructed to keep the 5 set Xerox copies with them selves of their
original documents until they are returned from Rajiv Gandhi University of Health
Sciences, Bangalore.Once submitted no original will be returned, please co-operate.
7. Overwriting, cutting, erasing in the form may lead to rejection and should be avoided.
Check thoroughly whether you have filled all your relevant details correctly in the
concerned forms.
8. Important: No forms / proforma will be issued at GIMS office as they are made available
in GIMS website. www.Karnataka.gov.in/gimsgadag
9. Institute working hours: 10.00 am to 1.30 pm and 2.15 pm to 5.30 pm.
10. Each candidate must submit the following original certificates shown below along with
three sets of attested true copies. The originals and Xerox must be produced in the
following sequence, failing to which there admission will be withheld and for that GIMS
will not be held responcible.
11. In case of AIQ/NEET seats-seat surrender procedure be duty followed. Kindly generate
the online seat surrender receipt and contact the AIQ officer of GIMS Dr.Anand Hugar
on 8971282391, message him. Please try to come on GIMS working day and remember
Karnataka holiday schedules will be different working days are Monday to Saturday,
SUNDAY WILL BE HOLIDAY. SECOND SATYRDAY AND GOVERNMENT OF
KARNATAKA HOLIDAYS will BE HOLIDAYS AS WELL AS NATIONAL
HOLIDAYS. KINDLY CALL ON OFFICE NUMBERS Mr.Ramesh 08372-297173/
274/224 and speak in Hindi or Kannada.
12. Learning Kannada for a medical student may be necessary since MBBS students are
interacting with patients.
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NOTE
1. Students admitted to this institute are expected to strictly follow the codes of discipline
indicated by college authorities, university, and government.
2. Drinking alcohol, smoking or consuming any intoxicants by students is strictly
prohibited. Misbehavior with girl students / women / patients will be dealt as per law.
3. Ragging in any form is punishable by law. An undertaking to this effect signed by the
candidate and his/her parent /guardian must be submitted at the time of admission
compulsorily.(all five affidavits)
4. Candidates are advised to keep a printed copy of their completed application form along
with forms for their record and future reference. You can photograph your submission
too.
5. As per RGUHS syllabus regulation 75% attendance in both practicals and theory is a
must. Nonadherence to such rules in force will invite disciplinary actions.It is also the
duty of parents/guardians to periodically ask for Internal marks and attendance of their
ward and participate in education process.A whatsapp group will be created for this batch
of students and maintained for the purpose of smooth conveyance of information
Dr.Roopa. (9742118485) be sent a SMS to include parents name in the whatsapp group.
Don’t include students name please.
6. No vehicles are allowed to be kept by students or used in the college permises.All parents
must agree to not allow their ward to not use any vehicles. If any parent wishes to allow
wards to use vehicles, they must submit a undertaking in Rs.100/- bond paper to warden.
7. Dress code – Decent formal dressing with shoes and socks is expected from both boys
and girls during working hours when visiting library similar rules apply. While roaming
in campus also kindly wear decent clothes.
8. Library rules and regulations must be followed.
9. Any Incidents of Ragging please report to Dr.Myageri (9986028269) or Dr.Raju (Vice
Principal 9844480528.
CONTACT DETAILS
PHONE : 08372 297213, 297214 (office) 297274
FAX : 08372 -297214
WEBSITE : www.Karnataka.gov.in/gimsgadag
EMAIL : [email protected]
Page 17
ADDRESS : Gadag Institute of Medical Sciences, Mulagund Road Mallasamudra, Gadag, Dist:Gadag,Karnataka,India.Pin Cod:5821
Check up will be done in first floor of GIMS Teaching Hospital/District Surgeon room
The Karnataka Service Regulations (Act.32) KARNATAKA MEDICAL DEPARTMENT
PHYSICAL FITNESS CERTIFICATE
1) In do hereby certify that I have examined…………………………………………………
……………………………………………………………………………………………..
a candidate for ……………………………………………………………………………..
And that I can not discover that He/She has any disease constitution affection or bodily
infirmity except…………………………………………………………………………….
Ido not consider this disqualification for employment in the office of …………………….
2) Iam also satisfied by personal examination/from certificate produced by that the H/She
was vaccinated/re-vaccinated with in one week prior to the date of the certificate.
3) ……………………………..’s age is according to His/her own statement……………….
years and by appearance about ………………………….year.
Other Particular’s
1. Height
2. Weight
3. Chest
4. Vision
Medical Superintendent,GIMS District Surgeon
District Hospital ,Gadag
Page 18
GENERAL RULES & REGULATIONS OF GIMS HOSTELS
1) Ragging in any form is banned inside and outside the campus. is punishable.
2) Students should strictly follow the timings of the hostel.
3) Extended hours for studying in the library will be granted on prior written permission.
4) Visitors including parents/guardians are allowed to meet the students in the visitors
lounge during visiting hours and not in their rooms. Overnight stay in the hostel is not
allowed. Entertaining unauthorized guests will lead to severe punishment including
expulsion from the hostel.
5) Students are not allowed to stay in rooms other than the ones allotted to them.
6) Students are responsible for the safety of their belongings. Kindly report any themselves
to warden office in working.
7) Use of tobacco in any form is strictly prohibited.
8) Consumption of alcohol is strictly prohibited.
9) Possession of weapons or dangerous chemicals of any kind is strictly prohibited.
10) Students will not get involved in political activities of any sort or participate in any
anti-national and anti-social or undesirable activity inside or outside the campus.
11) Students are not permitted to stay in rooms during the college hours, unless they are
ill. Any illness and medication student uses should be reported to the Warden.and
principal.
12) Students are not permitted to stay away from the hostel or leave station without the prior
permission from the warden/Principal.
13) Student once admitted to the hostel, cannot vacate it without a written request from their
parents which must be authorized by the Warden/ Principal.
14) Meetings/gathering within the hostel are not permitted. Functions of any kind should
have the prior permission of the Warden.
15) Students are allowed to use table lamps, hair dryers, iron box and chargers. The use of
other electrical appliances is not allowed.
16) Students have to keep their room clean and neat, including bathroom and toilet.
17) Students are not allowed to have meals in their rooms except under special conditions
like illness etc. The permission of the warden is required in such cases.
18) Cooking is not permitted in the hostel rooms.
Page 19
19) Students are not allowed to use terrace for any purpose without the prior permission of
the Warden.
20) Students are not allowed to use motor vehicles like bikes or cars. Those who are
authorized to use vehicles are required to park in an orderly manner in the space
provided. The students using vehicles should possess the valid driving license/ vehicle
registration documents.
21) Any damage to the hostel property will attract a fine. The students residing in the room is
responsible for any damage to the property within the room and will bear the cost of
damage. In case of damage or loss of hostel property the cost will be recovered from the
students of the hostel as decided by the Warden.
22) All students are required to maintain high standards of discipline in the college campus
and hostel premises. In case of breach of discipline and failure to abide by the rules and
regulations, the hostel committee will render the students liable to disciplinary action.
23) Any indisciplinary or undesirable activities occurring in the hostel should be brought to
the notice of the Warden/Principal.
24) Warden/Principal / Director are the final authority to take up decisions in any untoward
incidents.
SD/-
Wardens of Boys Hostel
SD/-
Wardens of Girls Hostel
SD/-
Principal
Gadag Institute of Medical Sciences
Gadag
Page 20
GIRLS HOSTEL RULES
1. Follow the hostel timings strictly
a. During the month of examination
b. -timing to go out-morning after 7.00 am
c. -timing to come in evening before 8.00
2. Fine for Keeping tap open – 1000/-Rs per person.
3. Fine for keeping fan, bulbs and electrical items on Rs – 500 per head
4. Mess bill has to be Paid before 10th of every month, if delayed 50/-Rs fine
a. Per day will be collected.
5. If the students want to go out of campus they have to take written
permission of warden.
6. Mess timings:
a. Tiffin :7.30am-9.00am
b. Lunch :12.30pm-3.00pm
c. Dinner :7.30pm-9.00pm
7. Mess bill – 2600 Rs per month – fixed, deduction will be considered if
remain absent for continuous five days.
8. No male relative is allowed to enter the room without permission.
9. Single lady companion is allowed to stay with the student with warden
permission.
10. NO SINGLE ROOMS ARE AVAILABLE FOR WHAT SO EVER
REASON AND SUCH REQUESTS WILL NOT BE ENTERTAINED ALL
room will be 3 seats rooms.
*** If students violate hostel rules and if any untoward incident happens,
students are responsible themselves & strict action will be taken.
SD/-
Chief Warden
Girls Hostel
GIMS Gadag
Page 21
UNDERTAKING BY THE PARENT
Rs 100/- bond paper to Hostel Warden. Vehicle DL Xerox copy to be submitted
with this bond. Of the student who wishes to keep vehicle in the campus.
I. ____________________ father of / guardian of _________________ /
mother of ______________ student of I / II /III MBBS herewith give a undertaking
to this effect that my child / ward ______________ has kept a vehicle __________
Model ________ Make _________ ____________
Vehicle No.___________ at GIMS campus. He/she in legally eligible to drive
vehicle and His/her vehicle DL is valid DL No is _______________ Any Mishaps/
accidents, any injuries to self others an account of driving by my ward is solely the
responsibility of my child and my self. I will not allow such vehicle to be driver
rashly or cause physical injury to other citizens. While driving such a vehicle my
child will ensure dignity of my family, college and such vehicle permission will
not be misused by letting or renting vehicle or flouting the MV act. Also such
vehicle driver shall display on vehicles the sign L for learner and per use Helmets
for himself/herself and the pillion rider.
Signature of child wishing to
Use vehicle Signature of parent
Mobile number Address
Witness (address with mobile no)
1.
2.
Page 22
ENVIRONMENTAL PLEDGE
(Each student must give this pledge)
I__________________________________S/O_____________________________
Hereby Pledge that I voluntarily agree to plant and maintain tree in my college
campus, and I will also take care of the plants/trees entrusted to me by the college
authorities. I shall participate in all such environment friendly activities assigned
to me with full dedication.
Signature of Candidate Signature of Parents
Page 23
RAJIV GANDHI UNIVERSITY OF HELTH SCIENCES BANGALORE
4TH
T BLOCK JAYANAGAR BANGALORE
NO RGU/EST/22/2011-12 DATE:04/01/2017
The following is the list of Government Holidays approved by Government of Karnataka.
SL.NO DATES GENERAL HOLIDAYS
DATES
1. 26/06/2017 EID
2. 15/08/2017 INDIPENDENCE DAY
3. 25/08/2017 VINAYAKA VRUTHA
4. 02/09/2017 BAKRID
5. 19/09/2017 MAHALAYA
6. 29/09/2017 MAHANAVAMI
7. 30/09/2017 MAHANAVAMI
8. 02/10/2017 GANDHI JAYANTI
Principal
Gadag Institute of Medical Sciences
Gadag
Page 24
COLLEGE FEES STRUCTURE
Sl
No Particulars
1st Year 2nd Year 3rd Year 4th Year
GM/OBC SC/ST AIQ
18
Month
18
Month
12
Month
12
Month
12
Month 12 Month
Gen SC/ST Gen SC/ST Gen SC/ST
1 Registration Fee
(University) 3500 3000 3500 - - - - - -
2 Admission Fee
(University) 1400 900 1400 - - - - - -
3 N.S.S (University) 50 50 50 - - - - - -
4 Sports Fee (University) 4
1/2 years 900 900 900 - - - - - -
5 Student Welfate fund (to
the University) 4 1/2 year 450 450 450 - - - - - -
6 Helinet Fee (University) 4
1/2 year 4500 4500 4500 - - - - - -
7 Tution Fee 9200 - 9200 13800 - 9200 - 9200 -
8 Library Fee 1500 1500 1500 2250 2250 1500 1500 1500 1500
9 Sports Fee (college) 600 600 600 900 900 600 600 600 600
10 Laboratory Fee 500 500 500 750 750 500 500 500 500
11 Medical examination Fee 150 150 150 225 225 150 150 150 150
12 Caution Mony Deposite
(Refundable) 1000 1000 1000 - - - - - -
13 Alumni Association Fee
(life time) 750 750 750 - - - - - -
14 Examination Fee 300 300 300 450 450 300 300 300 300
15 Marks card Fee - - - - - - - - -
16 Application Fee
(Admission) 100 100 100 - - - - - -
17 Fine - - - - - - - - -
18 Eligibility Fee - - - - - - - - -
19 Assocation Fee 500 500 500 750 750 500 500 500 500
20 Magazine Fee 500 500 500 750 750 500 500 500 500
21 Kannada Sangha 200 200 200 200 300 300 200 200 200
22 Identity Card 100 100 100 - - - - - -
23 Student Welfate fund (for
College) 350 350 350 350 350 350 350 350 350
24 Research Fees 100 100 100 100 100 100 100 100 100
25 Digital Library (College) 3600 3600 3600 3600 3600 3600 3600 3600 3600
26 Cultural activities
(College) 1500 1500 1500 1500 1500 1500 1500 1500 1500
27 Literary activities
(College) 500 500 500 500 500 500 500 500 500
GRAND TOTAL 32250 22050 32250 26125 12425 19600 10300 19500 10300
