FORM-1FORM 1FORM 1BRANCH COPYRGUHS COPYRGUHS GENERAL
ACCOUNTRGUHS GENERAL ACCOUNTSBM ACCOUNT NO. 54019480881SBM ACCOUNT
NO. 54019480881IFSC CODE: SBMY0040012IFSC CODE: SBMY0040012PAYABLE
AT ALL BRANCHES OF STATE BANK OF MYSOREPAYABLE AT ALL BRANCHES OF
STATE BANK OF MYSORERajiv Gandhi University of Health Sciences,
Karnataka.Rajiv Gandhi University of Health Sciences,
Karnataka.Name of the Bank:State Bank of MysoreName of the
Bank:State Bank of MysoreBranch NameBr.CodeBranch NameBr.CodeName
of the College /Student:Name of the College /Student:Address : Pin
:Address : Pin :Phone :Phone :Name of the Course:ClassI / II / III
/ IVName of the Course:ClassI / II / III / IVReg No.SubjectReg
No.SubjectSeparate Challans to be made for UG / PG/
SuperSpeciality/ Ph.d/ FellowshipSeparate Challans to be made for
UG / PG/ SuperSpeciality/ Ph.d/ FellowshipParticulars of Fee
RemittedAmountParticulars of Fee RemittedAmountI. APPLICATION FEE
(AFF / ADM/ OTHER)I. APPLICATION FEE (AFF / ADM/ OTHER)II. FEE -
AFFILIATIONII. FEE - AFFILIATION1.Fresh/Additional
Course1.Fresh/Additional Course2.Renewal (continuation)2.Renewal
(continuation)3.Annual Fee (continuation)3.Annual Fee
(continuation)4.Administrative & Service
Charges(cont)4.Administrative & Service Charges(cont)5.Increase
in intake UG/PG5.Increase in intake UG/PG6.Compliance Report
FeeLate fee/Penalty6.Compliance Report Fee7. Misc (Specify)7. Misc
(Specify)III. FEE - ADMISSIONIII. FEE -
ADMISSION1.Registration1.Registration2.Admission2.Admission3.Sports3.Sports4.Student
Welfare Fund4.Student Welfare Fund5 Late Admission /Submission Fee5
Late Admission /Submission Fee6.Additional Examination Fee
PG6.Additional Examination Fee PGIV. FEE - GENERALIV. FEE -
GENERAL1.Eligibility1.Eligibility2.Migration2.Migration3.NOC3.NOC4.Fee
collected under RTI Act4.Fee collected under RTI Act5.Sale of
Tender FORM5.Sale of Tender FORM6.Sale of old News Papers /
Records6.Sale of old News Papers / Records7.EMD7.EMD8.Misc Fee
(Specify)8.Misc Fee (Specify)T o t a l f e eT o t a l f e eAmount
(in words) RupeesAmount (in words) RupeesNOTE:FEE ONCE PAID WILLNOT
BE REFUNDEDNOTE:FEE ONCE PAID WILLNOT BE REFUNDEDDate: Signature of
the RemitterDate: Signature of the RemitterFOR THE USE OF BANK
ONLYFOR THE USE OF BANK ONLYAmount (in words) RupeesAmount (in
words) RupeesChallan No./ UTR No.:Challan No./ UTR No.:Date &
Bank SealSignature of the Cashier receiving the moneyDate &
Bank SealSignature of the Cashier receiving the money(To be
retainedin the BRANCH )(To be issued to the Remitter for submitting
along with application to University
FORM-2FORM 2FORM 2BRANCH COPYRGUHS COPYRGUHS EXAMINATION
ACCOUNTRGUHS EXAMINATION ACCOUNTSBM ACCOUNT NO. 54019480870SBM
ACCOUNT NO. 54019480870IFSC CODE: SBMY0040012IFSC CODE:
SBMY0040012PAYABLE AT ALL BRANCHES OF STATE BANK OF MYSOREPAYABLE
AT ALL BRANCHES OF STATE BANK OF MYSORERajiv Gandhi University of
Health Sciences, Karnataka.Rajiv Gandhi University of Health
Sciences, Karnataka.Name of the Bank:State Bank of MysoreName of
the Bank:State Bank of MysoreBranch NameBr.CodeBranch
NameBr.CodeName of the College /Student:Name of the College
/Student:Address : Pin :Address : Pin :Phone :Phone :Name of the
Course:ClassI / II / III / IVName of the Course:ClassI / II / III /
IVReg No.SubjectReg No.SubjectSeparate Challans to be made for UG /
PG/ SuperSpeciality/ Ph.d/ FellowshipSeparate Challans to be made
for UG / PG/ SuperSpeciality/ Ph.d/ FellowshipParticulars of Fee
RemittedAmountParticulars of Fee
RemittedAmount01.Application01.Application02.Exam02.Exam03.Dissertation03.Dissertation04.Retotalling
/ Answer Script Xerox04.Retotalling / Answer Script Xerox05.Marks
Card / Duplicate /Consolidate05.Marks Card / Duplicate
/Consolidate06.Provisional Degree Certificate06.Provisional Degree
Certificate07.Convocation / Rank Certificate07.Convocation / Rank
Certificate08.Transcript / Attestation /Name
Correction08.Transcript / Attestation /Name
Correction09.Penalty09.Penalty10.Others (SpecifY)10.Others
(SpecifY)T o t a l f e eT o t a l f e eAmount (in words)
RupeesAmount (in words) RupeesNOTE: FEE ONCE PAID WILL NOT BE
REFUNDEDNOTE: FEE ONCE PAID WILL NOT BE REFUNDEDDate: Signature of
the RemitterDate: Signature of the RemitterFor the use of the
BankFor the use of the BankAmount (in words) RupeesAmount (in
words) RupeesChallan No./ UTR No.:Challan No./ UTR No.:Date &
Bank SealSignature of the Cashier receiving the moneyDate &
Bank SealSignature of the Cashier receiving the money(To be
retainedin the BRANCH )(To be issued to the Remitter for submitting
along with application to University
FORM-3FORM 3FORM 3BRANCH COPYRGUHS COPYRGUHS HELINET
ACCOUNTRGUHS HELINET ACCOUNTSBM ACCOUNT NO.54019483532SBM ACCOUNT
NO.54019483532PAYABLE AT ALL BRANCHES OF STATE BANK OF
MYSOREPAYABLE AT ALL BRANCHES OF STATE BANK OF MYSOREPAYABLE AT ALL
BRANCHES OF STATE BANK OF MYSOREPAYABLE AT ALL BRANCHES OF STATE
BANK OF MYSORERajiv Gandhi University of Health Sciences,
Karnataka.Rajiv Gandhi University of Health Sciences,
Karnataka.Name of the Bank:State Bank of MysoreName of the
Bank:State Bank of MysoreBranch NameBranch NameName of the College
/Student:Name of the College /Student:Address : Pin :Address : Pin
:Phone :Phone :Name of the Course:Name of the Course:Class:I / II /
III / IVClass:I / II / III / IVReg No.Reg
No.Subject:Subject:Separate forms to be made for
UG/PG/SuperSpeciality/Ph.d/FellowshipSeparate forms to be made for
UG/PG/SuperSpeciality/Ph.d/FellowshipParticulars of fee
RemittedAmountParticulars of fee RemittedAmount1.Digital Library
Service Fee/PGDHL:1.Digital Library Service Fee/PGDHL:2.Helinet
Institutional fee :2.Helinet Institutional fee :3. Helinet Student
Registration Fee3. Helinet Student Registration
Fee4.Helinet-Student Fee:4.Helinet-Student Fee:5.Misc Fee
(Specify)5.Misc Fee (Specify)T o t a l f e eT o t a l f e eAmount
(in words) RupeesAmount (in words) RupeesNOTE: ONCE PAID WILL NOT
BE REFUNDEDNOTE: ONCE PAID WILL NOT BE REFUNDEDDate: Signature of
the RemitterDate: Signature of the RemitterFor the use of the
BankFor the use of the BankAmount (in words) RupeesAmount (in
words) RupeesChallan No./ UTR No.:Challan No./ UTR No.:Date &
Bank SealSignature of the Cashier receiving the moneyDate &
Bank SealSignature of the Cashier receiving the money(To be
retainedin the BRANCH )(To be issued to the Remitter for submitting
along with application to University)
FORM-4FORM 4FORM 4BRANCH COPYRGUHS COPYRGUHS GENERAL
ACCOUNTRGUHS GENERAL ACCOUNTSBM ACCOUNT NO. 54019530822SBM ACCOUNT
NO. 54019530822IFSC CODE: SBMY0040012IFSC CODE: SBMY0040012PAYABLE
AT ALL BRANCHES OF STATE BANK OF MYSOREPAYABLE AT ALL BRANCHES OF
STATE BANK OF MYSORERajiv Gandhi University of Health Sciences,
Karnataka.Rajiv Gandhi University of Health Sciences,
Karnataka.Name of the Bank:State Bank of MysoreName of the
Bank:State Bank of MysoreBranch NameBr.CodeBranch NameBr.CodeName
of the College /Student:Name of the College /Student:Address : Pin
:Address : Pin :Phone :Phone :Name of the Course:ClassI / II / III
/ IVName of the Course:ClassI / II / III / IVReg No.SubjectReg
No.SubjectSeparate FORMs to be made for
UG/PG/SuperSpeciality/Ph.d/FellowshipSeparate FORMs to be made for
UG/PG/SuperSpeciality/Ph.d/FellowshipParticulars of fee
RemittedAmountParticulars of fee RemittedAmount01. NSS REGULAR01.
NSS REGULAR02.MISC FEE (Specify)02.MISC FEE (Specify)T o t a l f e
eT o t a l f e eAmount (in words) RupeesAmount (in words)
RupeesNOTE: FEE ONCE PAID WILL NOT BE REFUNDEDNOTE: FEE ONCE PAID
WILL NOT BE REFUNDEDDate: Signature of the RemitterDate: Signature
of the RemitterFor the use of the BankFor the use of the BankAmount
(in words) RupeesAmount (in words) RupeesChallan No./ UTR
No.:Challan No./ UTR No.:Date & Bank SealSignature of the
Cashier receiving the moneyDate & Bank SealSignature of the
Cashier receiving the money(To be retainedin the BRANCH )(To be
issued to the Remitter for submitting along with application to
University
FORM-5FORM-5FORM-5BRANCH COPYRGUHS COPYRGUHS GENERAL
ACCOUNTRGUHS GENERAL ACCOUNTSBM ACCOUNT NO. 54019529374SBM ACCOUNT
NO. 54019529374IFSC CODE: SBMY0040012IFSC CODE: SBMY0040012PAYABLE
AT ALL BRANCHES OF STATE BANK OF MYSOREPAYABLE AT ALL BRANCHES OF
STATE BANK OF MYSORERajiv Gandhi University of Health Sciences,
Karnataka.Rajiv Gandhi University of Health Sciences,
Karnataka.Name of the Bank:State Bank of MysoreName of the
Bank:State Bank of MysoreBranch NameBr.CodeBranch NameBr.CodeName
of the College /Student:Name of the College /Student:Address : Pin
:Address : Pin :Phone :Phone :Name of the Course:ClassI / II / III
/ IVName of the Course:ClassI / II / III / IVReg No.SubjectReg
No.SubjectSeparate Challans to be made for UG / PG/
SuperSpeciality/ Ph.d/ FellowshipSeparate Challans to be made for
UG / PG/ SuperSpeciality/ Ph.d/ FellowshipParticulars of Fee
RemittedAmountParticulars of Fee RemittedAmount01.P G E T
Application01.P G E T Application02.P G E T Fee02.P G E T Fee03.P G
E T Superspeciality03.P G E T Superspeciality04.Others
(Specify)04.Others (Specify)T o t a l f e eT o t a l f e eAmount
(in words) RupeesAmount (in words) RupeesNote:once paid will not be
refundedNote:once paid will not be refundedDate: Signature of the
RemitterDate: Signature of the RemitterFor the use of the BankFor
the use of the BankAmount (in words) Rupees .Amount (in words)
Rupees .........Challan No.Challan No.Date & Bank SealSignature
of the Cashier receiving the moneyDate & Bank SealSignature of
the Cashier receiving the money(To be retainedin the BRANCH )(To be
issued to the Remitter for submitting along with application to
University
