Application Form Aieee 2011
Application Form Aieee 2011
(1/10)
Rajasthan
Candidate
Applications are invited from those candidates only who belong to any State First year of degree engineering courses on the basis of AIEEE rank on 15% seats in the Private Unaided Engineering Institutions and 15% seats in the Self-Financed Courses in Govt. Aided Engineering Institutions of Rajasthan State (except MNIT, BITS Pilani and other deemed and Private universities).
Eligibilit : The candidate who belongs to any State other than Rajasthan and must have passed 10+2 or any other y examination recognized equivalent thereto by Board of Secondary Education, Rajasthan, with atleast 45% marks in the subjects combination as given below taken together, in the final examination of 10+2 (Class XII). Course Compulsory Subjects Any one of the Optional Subjects B.Tech./ B.E. Physics & Mathematics (1) Chemistry (2) Bio-technology (3) Computer Science (4) Biology The candidates having zero or negative marks in AIEEE-2011 will not be eligible. Age Limit : Only those candidates whose date of birth falls on or after October 01, 1986 are eligible. However, in the case of Scheduled Caste (SC), Scheduled Tribe (ST) and Physically Handicapped (PH) candidates, upper age limit is relaxed by 5 years, i.e. SC, ST and PH candidates who were born on or after October 01, 1981 are eligible. Date of birth as recorded in the Secondary Education marksheet / certificate only will be taken as authentic. How to Apply : A candidate will have to apply on prescribed Application Form along with Option Form, which are to be downloaded from our Web Sites. Completely filled Application Form along with all required documents should reach to : The Coordinator, RPET-2011 Board of Technical Education, Rajasthan W-6, Residency Road, Jodhpur Rajasthan-342032 Last Date for Receipt of Application Form time shall not be accepted. : 28 t h JULY, 2011 upto 5.00 PM. Applications received after last date and
Demand Draft with Application Form : 11000/- in favour of Coordinator RPET-2011 payable at Jodhpur. The description of this amount is as stated below : A. Rs. 1000/- as Application form fees (Non Refundable) B. Rs. 10000/- to be adjusted against admission fees. (Forfeited if candidate deny to join in the allotted institute as per Option Form and merit.) Documents to be Enclosed with Application form : 1. Option form duly filled in by the candidate in original. t h /11 th in support of the proof for Date of birth. 2. Attested photo copy of Mark sheet / Certificate of class 10 t h in support of the proof for the qualifying examination. 3. Attested photo copy of Mark sheet of class 12 4. Attested photo copy of AIEEE Rank card. 5. Attested photo copy of certificate of your concerned state domicile (As a proof of candidates belonging to any State other than Rajasthan State). 6. A demand draft of Rs. 11000/- in favour of Coordinator RPET-2011 payable at Jodhpur. Merit List : A common merit list of all the eligible candidates shall be declared on the basis of All India Rank in AIEEE. The merit list will be available on our websites as per the schedule given below. Counselling Through Option The counselling shall be carried out through option form on the basis of the merit Form : and options filled by the candidate in the option form. The candidates are required to fill up the option form (which is available on the website) and submit it along with the prescribed application form. The seats available for Out of Rajasthan candidates, in the colleges situated in Rajasthan i.e. SEAT MATRIX is available on the website. The Institute and Branch codes are available in the seat matrix itself. The allotment of seats will be strictly according to the merit of the candidate and as per the options filled by candidate in the option form. The allotment of the Institutes and Branch will be available on the website as per the schedule given below. If a candidate does not report in the allotted institution then his/her fees (i.e. Rs. 10,000/-) deposited along with the option form will be forfeited. Important Dates : S.No. Particulars Date Last date for submission of application form in RPET-2011 office 28-07-2011 1. 2. Declaration of merit list on web sites 04-08-2011 3. Declaration of allotment list on web sites 06-08-2011 4. Last Date of Reporting in the allotted institutions. Will be informed on website Candidates are advised to visit our websites regularly for related updated information.
Coordinator
Board of Jodhpur
(2/10)
of Submission : 28-07-2011
st (Application form for the candidates who belong to any State other than Rajasthan State for admission to 1 year of degree engineering courses on the basis of AIEEE rank on 15% seats in the Private Unaided Engineering Institutions and 15% seats in the Self-Financed Courses in Govt. Aided Engineering Institutions of Rajasthan State)
_______________________________________ _______________________________________
Affix passport size photograph duly signe d by candidate and attested by Gazetted Office r
______________________________________________________
________________________________________________________________
(Please Tick (
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9. Academic Qualification: Class Name of Boar d / State Pass Year Percentage X Secondary / Sr. Secondary / XII 10. Details of marks in XII : Subject Maximum Marks Marks Mathematics Obtained
Physics Chemistry / Bio-technology / Computer Science / Biology Total Percentage (%)
11. AIEEE Ranking (AIR) __________________________ AIEEE Roll No___________ 12. DD No. _____________ DD Da te ________ Bank _______________ DD Amount : 11000/Enclose the following ( P l e as e T i c k ( ) aft e r e n su ri n g t ha t y ou ha v e at t ac h e d t he s e d oc um e nt s ) Option form duly filled in by the candidate in original. Attested photo copy of Mark sheet / Certificate of class 10 th /11 th in support of the proof for Date of birth Attested photo copy of Mark sheet of class 12 th Attested photo copy of AIEEE Rank card Attested photo copy of certificate of your concerned State domicile (As a proof of candidates belonging to any State other than Rajasthan State) A demand draft of Rs. 11000/- in favour of Coordinator RPET-2011 payable at Jodhpur.
De claration I hereby solemnly and sincerely affirm that all the information furnished
by me in this application form are true and correct. I have not concealed any information. However, if any information furnished herein is found to be fraudulent, incorrect or untrue at any stage, I am liable to criminal prosecution and I also agree to forgo my seat. Further that the selection and admission to the course is liable to be cancelled. I agree to abide by the Rules and Regulations.
Date :
Signature of Candidate
RPET-2011
Inst. Branch Ch. 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 Inst. Branch
AIEEE Name :
Ch. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
Roll
No.
:
Ch. 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 Inst. Branch Ch. 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 Branch Branch Code Declaration Inst. Branch Ch. 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128
Inst.
Branch
I have filled ----------------- No. of options. I have gone through all the instructions and rules to fill this option form. In case, a seat is allotted to me as per options filled in by me, then I will report in the allotted institutions on the scheduled date and time as decided by the Coordinator RPET2011. I will not claim any refund of the above said fees if, I deny to join the allotted institute. I full fill all the eligibility criteria as required by RPET-2011. I accept that if any information is detected as false at any stage then my candidature will be cancelled. All the information filled in this option form are true and correct to the best of my knowledge and belief.
Date: Signature of Candidate
(4 / 1 0)
Institute-wise tentative Seat Matrix (Out of Rajasthan Quota Through AIEEE rank) for Engineering Colleges
Name of Branch (Branch Code)
Name Code)
of
Institution
(Institution
Self-Financed Govt. Engineering Colleges ( First Engineering 54 7 3 7 ) College, Ajmer (001) 9 14 Shift 9 5 54 7 3 7 9 College, Engineering 9 14 M.L.V. Textile &Ajmer (001) College, Bhilwara (002) Engineering 5 Engineering College Bikaner (003) M.B.M. Engineering College, Jodhpur (004) University College of Engineering, Kota (005) 9 9 13 9 4 9 5 5 College of Technology & Engg. Udaipur (006) 6 6 6 6 9 6 1 54 Govt. Engineering College, Jhalawar (051) 9 9 9 9 9 9 54 Govt. Mahila College, Jhalawar (051) 9 9 (052) Govt. Engineering Engineering College, Ajmer 9 9 9 9 Govt. Engineering College, Bharatpur (053) 9 9 9 9 9 9 College of Engineering & Technology, Bikaner (054) 9 9 18 9 9 9 Private Engineering Colleges ( First Shift ) Ajmer Institute of Technology, Ajmer (007) 5 18 18 5 9 9 90 18 18 9 18 18 9 Inst. of Engg. & Technology, Alwar (008) 90 of 18 18 9 18 18 9 Margaret Engg. College, Neemrana, Inst. St. Engg. & Technology, Alwar (008) Alwar (010) 14 9 18 9 18 Inst. of Technology & Mgt., Bhilwara (011) Marudhar Engg. College, Bikaner (012) Apex Institute of Engg. & Technology, Jaipur (013) 14 9 18 18 9 81 Arya College of Engg. & Infor. Technology, Kukas, Jaipur (014) 9 18 9 18 9 18 81 College of Mirdha Infor. Technology, Kukas, (015) (014) 9 18 9 AryaBaldev RamEngg. & Inst. of Technology, Jaipur Jaipur 18 18 27 18 18 9 18 Global Institute of Technology, Jaipur (016) Presidency College of Engineering, Kota (017) 9 9 18 9 9 18 Jagan Nath Gupta Institute of Engg. & Technology, Jaipur (018) 18 9 18 9 9 Jaipur Engineering College, Kukas, Jaipur (019) 18 9 18 9 18 Jaipur Engineering College & Research Centre, Jaipur (020) 9 18 9 27 14 14 91 Jaipur Engineering College & Research Centre, Jaipur (021) 14189 14 9 9 14 91 Kautilya Institute of Technology & Engg., Jaipur (020) 9 9 9 27 14 Maharishi Arvind Inst. of Engg. & Technology, Jaipur (022) 18 18 9 18 18 18 9 18 9 9 18 9 18 9 9 18 18 9 18 9 9 18 18 9 9 14 9 9 14 9 9
999396 5999
45 64 32 63 40 54 54 63 64 68 63 81 68 81 81 72 63 72 64 63
(5 / 1 0)
Institute-wise tentative Seat Matrix (Out of Rajasthan Quota Through AIEEE rank) for Engineering Colleges
Name of Branch (Branch Code)
Name Code)
of
Institution
(Institution
Poornima College of Engineering, Jaipur (023) 9 18 27 9 18 9 18 Rajasthan College of Engg. for Women, Jaipur (024) 18 9 18 18 63 Rajasthan College of Engg. for Women, Jaipur (024) 18(025) 18 14 14 9 9 63 Rajasthan Institute of Engg. & Technology, Jaipur 9 18 18 Regional College for Education, Research & Tech., Jaipur (026) 18 9 18 9 9 Global Collge of Technology, Jaipur (027) Shankara Institute of Technology, Kukas, Jaipur (028) 5 14 9 18 9 18 Sri Balaji College of Engg. & Technology, Jaipur (029) 18 9 9 18 9 9 Stani Memorial College of Engg. & Tech., Phagi, Jaipur (030) 9 9 9 18 9 9 63 StaniSwami Keshwanandof Engg. & Tech., Phagi, Jaipur (030) 9 9 9(031) 9 18 18 14 14 18 63 Memorial College Instt. of Tech. Mgt. & Gramothan, Jaipur 18 9 9 Yagyavalkya Institute of Technology, Jaipur (032) 9 9 9 18 9 9 Shekhawati Engineering College, Dundlod, Jhunjhunu (033) 9 18 14 14 9 Bhartiya Institute of Engineering & Technology, Sikar (034) 9 14 9 14 9 9 Jodhpur Institute of Engineering & Technology, Jodhpur (035) 9 18 9 18 9 18 64 Marwar Engineering College & Research Centre, Jodhpur (036) 9 9 14 18 14 64 Modi Institute of Technology, Kota (037) Marwar Engineering College & Research Centre, Jodhpur (036) 9 9 14 18 14 Compucom Institute of Information Technology, Jaipur (038) 18 9 9 9 18 R. N. Modi Engineering College, Kota (039) 18 18 18 9 Srinathji Instt. of Technology & Engg. Nathdwara, Rajsamand (040) 18 14 18 5 9 64 Sobhasaria Engineering College, Sikar (041) 5 9 18 5 18 9 64 Geetanjali Institute College, Sikar (041) 9 18 5 (042) Sobhasaria Engineering of Technical Studies,5Udaipur18 9 18 9 18 9 Vedant College of Engineering & Technology, Bundi (043) 9 9 18 9 9 Alwar Institute of Engineering & Technology, Alwar (044) 18 18 18 9 5 Arya Institute of Engineering & Technology, Kukas, Jaipur (045) 18 9 27 18 9 Siddhi Vinayak College of Science & Higher Education, Alwar (047) 14 14 14 9 9 Arya 63 College of Engineering & Research Centre, Jaipur (048) 18 18 9 9 9 AryaB K Birlaof Engineering & Research Centre,Pilani, Jhunjhunu (049) 9 18 9 9 9 63 College Institute of Engg. & Technology, Jaipur (048) 18 18 9 9 9 18 9 18 5 9 9 9 9 18 9
108 64 63 54 73 72 91 63 64 64 81 59 63 63 64 54 54 68 81 60 54
(6 / 1 0)
Institute-wise tentative Seat Matrix (Out of Rajasthan Quota Through AIEEE rank) for Engineering Colleges
Name of Branch (Branch Code)
Name Code)
of
Institution
(Institution
Poornima Institute of Engineering & Technology, Jaipur (050) 18 18 9 18 9 JIET 72 School of Engineering & Technology for Girls, Jodhpur (055) 18 18 18 18 JIETBaldev Ram Mirdha Inst. of Tech. (East Campus), Jaipur (055) 18 1818 918 72 School of Engineering & Technology for Girls, Jodhpur (056) 18 9 18 Gurukul Institute of Engineering & Technology, Kota (057) 9 9 18 9 9 9 Mahatma Gandhi Engineering College, Jaipur (058) 18 9 9 9 9 Maharaishi Arvind International Inst. of Technology, Kota (059) 18 14 9 9 9 9 Modern Institute of Technology & Research Centre, Alwar (060) 9 18 9 14 9 9 63 Sri Ganganagar Engineering College, Sri Ganganagar (061) 18 18 9 9 9 63 Uttam Devi Mohanlal College of Engineering, Jaipur (062) 18 9 Sri Ganganagar Engineering College, Sri Ganganagar (061) 18 18 9 1899 9 Vyas Institute of Engineering & Technology, Jodhpur (063) 18 9 18 9 9 9 Vyas Engineering College for Girls, Jodhpur (064) 14 9 18 14 SLBS Engineering College, Jodhpur (065) Bansal School of Engineering & Technology, Jaipur (066) 14 9 9 9 Rajdhani Institute of Technology & Management, Jaipur (067) Rajdhani Institute Institute of Management, Engg. & Tech., Jaipur 18 14 1818 18 9 9 International of Technology & Management, Jaipur (067) 14 (068) 9 9 Vivekanand Intitute of Technology, Jaipur (069) 18 18 18 9 9 Vivekanand Intitute of Technology (East), Jaipur (070) 18 9 18 9 18 Aravali Institute of Technical Study, Udaipur (071) 18 9 9 18 64 Maharaja College of Engineering, Udaipur (072) 9 14 9 9 9 14 64 S.S. College of Engineering, Udaipur (072) MaharajaCollege of Engineering, Udaipur (074) 9 14 9 9 9 14 Techno India NJR Institute of Technology, Udaipur (075) 9 9 9 9 9 Poornima Group of Institutions, Jaipur (078) 18 9 18 18 Jaipur Institute of Engineering & Technology, Jaipur (079) 9 9 18 9 18 Maharishi Arvind College of Engg. & Research Center, Jaipur (080) 9 9 9 9 9 18 Shri 36 Bhawani Niketan Inst. of Tech. & Management, Jaipur (081) 9 9 9 9 Shri *Chartered Institute of of Tech. & Management,Sirohi (082) 9999 9 9 9 36 Bhawani Niketan Inst. Technology, Abu Road, Jaipur (081) 18 9 14 9 9 18 9 9 9 18 9 9 9
72 54 63 54 68 68 54 72 55 72 41 73 63 72 72 54 59 45 63 63 63 45
(7 / 1 0)
Institute-wise tentative Seat Matrix (Out of Rajasthan Quota Through AIEEE rank) for Engineering Colleges
Name of Branch (Branch Code)
Name Code)
of
Institution
(Institution
Chandravati Edu. Charitable Trust Group of Inst., Bharatpur (083) 18 9 9 18 9 *Rajasthan Institute of Engg. & Technology, Chittorgarh (084) 18 9 9 9 9 54 *Rajasthan Institute of Engg. & Technology,Dungarpur (085) 9 18 9 9 9 9 54 *Dungarpur College of Engg. & Tech., Chittorgarh (084) 9 9 9 9 9 *Shree Digambar Institute of Technology, Mitrapura,Dausa (086) 9 9 18 9 9 9 Manda Institute of Technology, Bikaner (087) 9 9 18 9 9 *Tagore Engineering College, Kuchaman City, Nagaur (088) 9 9 18 9 9 St. Wilfred's Institute of Engineering & Technology, Ajmer (089) 9 18 18 9 9 63 Shekhawati Inst. of Engg. & Technology, Sikar (090) 9 9 9 18 9 9 63 Shri U.S.B. of Engg. & Technology, Sikar (090) 9 Road, 9 9 Shekhawati Inst. College of Engg. & Management, Abu 9 9 18 Sirohi (091) 9 9 9 9 9 Shekhawati Girls Engineering College, Dundlod, Jhunjhunu (092) 14 9 14 9 *Asians Institute of Technology, Bhurtia, Tonk (093) 9 9 9 9 9 9 Pacific Institute of Engineering, Udaipur (095) 18 9 18 18 Pacific College of Engineering, Udaipur (096) 9 9 9 18 18 Siddhi Vinayak Engineering & Management College, Alwar (097) Siddhi Vinayak Engineering Engg. & Technology, Jodhpur (098) 9 9 9 9 9 9 9 Mayurakshi Institute of & Management College, Alwar (097) 9 9 9 9 Raj Engineering College, Jodhpur (099) Marwar Institute of Technology, Jodhpur (100) 9 9 9 9 9 Surendra Group of Institutions, Sriganganagar (101) 9 9 9 9 18 Jaipur Institute of Engineering & Management, Jaipur (102) 9 9 9 9 9 45 Jaipur Institute of Engineering & Management, Jaipur (102) 9 9(103) 18 9 9 9 9 45 Jaipur Institute of Technology Group of Institution, Jaipur 9 9 9 Apex Group of Institutions, Jaipur (104) Rajdhani Engineering College, Jaipur (105) 18 9 9 9 9 Deepshikha Kala Sansthan Group of Institutions, Vatika, Jaipur (106) 9 9 9 9 18 Dr. Radhakrishnan Institute of Technology, Jaipur (107) 18 9 9 9 9 45 Biyani International Institute of Engg. & Tech. For Girls, Jaipur (108) 9 9 9 9 9 45 Dr. Radakrishnan Institute Engg. & Tech. For Girls, Jaipur (108) 9 9 9 9 9 Biyani International Institute of of Technology for Women, Jaipur (109) 9 9 9 9 9 99999
63 54 63 54 54 63 45 46 54 63 63 54 45 45 45 54 54 18 9 9 9 9 54 54 54 54 45
(8 / 1 0)
Institute-wise tentative Seat Matrix (Out of Rajasthan Quota Through AIEEE rank) for Engineering Colleges
Name of Branch (Branch Code)
Name Code)
of
Institution
(Institution
Sine International Institute of Technology, Jaipur (110) 18 9 9 9 9 Pink 45 City Engineering College & Research Center, Jaipur (111) 9 9 9 9 9 PinkS.J. College of Engineering & Technology , Dausa (112) 18999999999 45 City Engineering College & Research Center, Jaipur (111) Rajasthan Engineering College, Dausa (113) 9 9 18 9 9 CLG Institute of Engineering and Technology, Sumerpur, Pali (114) 9 9 9 9 9 Nathdwara Institute of Engg. & Tech., Nathdwara, Rajsamand (115) 9 9 9 9 Buddha Group of Institutions, Udaipur (116) 9 9 9 9 9 Sunrise Group of institutions, Udaipur (117) 54 99999 Sunrise9 54 9 Group of institutions, Udaipur (117) 9 9 9Keystone Group of Institutions, Surajgarh, Jhunjhunu (118) 9 9 9 9 9 9 Saraf Institute of Engineering & Technology, Hanumangarh (119) 9 9 9 18 9 Biff & Bright College of Engineering & Technology, Dudu, Jaipur (120) 9 9 9 9 9 9 *Regional Engineering College, Dhamotar, Pratapgarh (121) 9 9 18 9 9 Aryabhatta College of Engg. & Research Center, Ajmer (122) 9 9 9 9 9 9 Faculty of Engg. & Tech. (JRN Raj. Vidyapeet), Udaipur (123) 9 9 9 9 9 Anand International College of Engineering, Jaipur (124) 9 9 9 9 18 BLM Institute of Tech. & Management Sc., Khetri, Jhunjhunu (125) 9 9 9 9 Chanakya Technical Campus, Jaipur (126) Northern Institutute of Engg. & Technical Campus, Alwar (127) 9 9 9 9 9 45 Poddar Management & Technical Campus, Jaipur (128) 9 9 9 9 9 45 Private Engineering Colleges ( Second Shift ) Poddar Management & Technical Campus, Jaipur (128) 9 9 9 9 9 Ajmer Institute of Technology, Ajmer (151) Institute of Engineering & Technology, Alwar (152) 9 9 9 Institute of Technology & Managementgt, Bhilwara (154) 9 9 Marudhar Engineering College, Bikaner (155) Arya 18 College of Engg. & Information Technology, Jaipur (156) 9 9 AryaBaldev RamEngg. & Institute of Technology, Jaipur (157) 9 9 9 18 College of Mirdha Information Technology, Jaipur (156) 9 9999 99 99999 999999
54 54 54 45 36 45 54 54 54 54 54 45 54 36 45 45
18 27 18 36 18
(9 / 1 0)
Institute-wise tentative Seat Matrix (Out of Rajasthan Quota Through AIEEE rank) for Engineering Colleges
Name of Branch (Branch Code)
Name Code)
of
Institution
(Institution
Global Institute of Technology, Jaipur (158) Jagan Nath Gupta Institute of Engg. & Tech., Jaipur (159) 9 9 18 Jagan Nath Gupta Institute of Engg. & Tech., Jaipur (159) 9 9 18 Kautilya Institute of Technology & Engineering, Jaipur (160) 9 9 Maharishi Arvind Institute of Engg. & Technology, Jaipur (161) 9 9 Poornima College of Engineering, Jaipur (162) Rajasthan College of Engineering for Women, Jaipur (163) 9 9 Rajasthan Institute of Engineering & Technology, Jaipur (164) 9 9 Regional College for Education, Research & Tech., Jaipur (165) 9 9 9 27 Regional College for Education, Research & Tech., Jaipur (165) 9 9 9 27 Shankara Institute of Technology, Jaipur (166) Sri Balaji College of Engineering & Technology, Jaipur (167) 9 9 9 Swami Keshwanand Inst. of Tech. Mgt. & Gramothan, Jaipur (168) 9 9 9 Yagyavalkya Institute of Technology, Jaipur (169) 9 9 Shekhawati Engineering College, Dundlod, Jhunjhunu (170) 9 9 36 Jodhpur Institute of Engineering & Technology, Jodhpur (171) 9 9 9 9 36 Sobhasaria Engineering College, Sikar (172) Jodhpur Institute of Engineering & Technology, Jodhpur (171) 9 9 9 9 Alwar Institute of Engineering & Technology, Alwar (173) 9 9 9 Arya Institute of Engineering & Technology, Jaipur (174) 9 9
9999
36 18 18
9999
36 18 18 99 18 27 27 18 18
999
27 27 18
Branch names are as per nomenclature of the Universities of Rajasthan. The institutes should get the names changed from AICTE as per University nomenclature. It may be noted that the fee for the session 2011-12 will be finalized shortly by the State Govt. The candidates are required to pay the revised fee accordingly. For reference, the intrim annual fee structure in 2010-11 was Rs. 50,000 for Engineering reference, the intrim annual fee structure in 2010-11 was Rs. 50,000 for Engineering
OF MEDICAL FITNESS CERTIFICATE (To be produced at the time of reporting in the allotted (Kindly issue this certificateonly when the candidate is according to the standards given below) institute)
I / Dr._________________ (Name & Designation Posted ___________________________ (Name of Hospital & Place) Certify that I have carefully examined ________________________ (Name of Candidate) S/o. D/o. Shri __________________________ fits _______________________________ )
in
(10/10)
Rajasthan,
whose
photograph attested by me is affixed-here with. As a result of his/her medical examination. I have discovered nothing that may disqualify him/her from admission to a under graduate degree courses in Engineering Institutions of Rajasthan according to the standards of medical fitness prescribed below. I have to further report that :
He/She has no disease or mental or bodily infirmity making him/her unfit or likely to ma ke him/her unfit in the near future for active out door duty, as an Engineer.
Marks of identification___________________________________________________ Hence the candidate is fit as per standards given below for admission to Engineering Institutions in Rajasthan.
Signature of Candidate
Medical fitness Standards : The candidates must subscribe to medical standard laid down 1. Height : Not less that 1.5 m for male candidate and not less than 1.4 m for female candidates. below:
2. Weight: Not less than 41 Kg. Approx. for male candidate and 37 Kg. Approx for female candidates. 3. Chest Measurement: Not less than 69 cm with satisfactory limits of expansion and contraction (for Male candidates only) 4. Heart & Lungs: No abnormality. 5. Hernia, Hydrocele, Piles etc. :- Presence of any of these will be a temporary disqualification to be rectified before joining the courses of study. 6. Vision : Normal, where defective, it must be corrected to 6/9 in the better eye and 6/12 in the worse eye. Eyes should be free from contigential and other diseases. In case of admission to Mining Engineering course, the candidates must be free from colour blindness (Inability to distinguish between principal colour) also . 7. Hearing : Normal. Where defective, it must be corrected. 8. Speech : Normal