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Application Prospectus of HIHT Himalayan Institute Hospital Trust PGMEE 2012

Application Prospectus of HIHT Himalayan Institute Hospital Trust PGMEE 2012

Postgraduate – Medical Entrance Examination For admission into various Postgraduate Medical Courses – 2012 PGMEE – 2012

Application Forms can be downloaded from University website:
www.hihtuniversity.edu.in from 16th November 2011 onwards
• Last date for submission of Completed
application forms : 31st January 2012
• Date & Time of Entrance Examination : 19th Feb 2012, Sunday
10:00 A.M. To 01:00 P.M.
• Declaration of Result : By the end of February 2012

Application form complete in all respect must be accompanied with a draft of 2000/- (rupees two thousand only) drawn in favour of HIHT University payable at State Bank of India, Jolly Grant (Branch code No- 10580), Dehradun

I
Postgraduate – Medical Entrance Examination For
admission into various Postgraduate Medical Courses – 2012
PGMEE – 2012
Information Brochure & Application Form

HIHT
UNIVERSITY
www.hihtuniversity.edu.in
Swami Ram Nagar,
P.O. Doiwala, Dehradun, Uttarakhand (INDIA)
Phone : 0135 – 2471150 II
AT A GLANCE
Application Forms can be downloaded from University website:
www.hihtuniversity.edu.in from 16th
November 2011 onwards
• Last date for submission of Completed
application forms : 31st January 2012
• Date & Time of Entrance Examination : 19th Feb 2012, Sunday
10:00 A.M. To 01:00 P.M.

• Declaration of Result : By the end of February 2012

Application form complete in all respect must be accompanied with a draft of
“` 2000/- (rupees two thousand only) drawn in favour of HIHT University
payable at State Bank of India, Jolly Grant (Branch code No- 10580), Dehradun.
IMPORTANT
No claim for refund of fee, paid for PGMEE – 2012, shall be entertained. III
CONTENTS
Page No.
1. Introduction 1

2. Definitions 1
3. Ban on Ragging 1-2
4. Courses offered with seats available 2-3
5. Eligibility Criteria 3
6. Pattern & Syllabus of Examination 3
7. Schedule of Examination 3
8. Centre for Examinations 4
9. Instructions for completing and sending the Application Form 4-5

10. Admit Card 5-6
11. Instructions For Examination 6-8
11.1 The Answer Sheet
11.2 Marking System
11.3 Rough Work
12. Merit List 8

13. Declaration of Result 8
14. Preservation of Records 8
15. Instructions for Counseling/Admission 9-10
Appendix I – Fee Structure 11
Appendix II – Application form for PGMEE – 2012. 12
Appendix III – Admit Card for PGMEE – 2012 13
Appendix IV – Specimen copy of Authority Letter 14
Appendix V – Specimen copy of Undertaking Regarding Authorization 15
Appendix VI – Specimen copy of Affidavit against ragging – by the student 16
Appendix VII – Specimen copy of Affidavit against ragging – by parent/guardian 17
Appendix VIII – Specimen copy of Answer Sheet 18-19
Appendix IX – Checklist (before sending the Application for PGMEE – 2012). 20 1
1. INTRODUCTION
HIHT University has been granted deemed to be University status vide
notification number F.9-43/2006-U.3(A) dated 6th June, 2007 by the Govt. of
India, Ministry of Human Resource Development. For details about the University
please visit our website www.hihtuniversity.edu.in.
The University invites application from the eligible candidates for admission into
various postgraduate medical courses conducted by its medical college (Himalayan
Institute of Medical Sciences) for the academic year 2012 – 13.
The Postgraduate medical courses of this University are recognized by M.C.I.
1.1 ABOUT THE INSTITUTE
The Himalayan Institute was founded by a great yogi,
scientist, philosopher, philanthropist, researcher and writer
H.H. Dr. Swami Rama. This is the only Post Graduate
Medical Institute in Uttarakhand State. It is a unique model
of education in the country. Emphasis is on community
oriented medical education focusing on preventive, promotive,
curative health care, evolving a new pattern of medical
education and health care by incorporating a spiritual basis
of life in relation to health and modern technology and
training students in the science and art of medicine,
matching with international standards.
The Institute is situated in the foothills of the Himalayas on the Dehradun –
Rishikesh Highway, 25 kms from Dehradun and 18 kms from Rishikesh. The
Institute presently has a 700 bedded multi specialty Hospital along with
residences for Doctors and Staff.
The College also has the hostel & mess facility inside the campus & provides
excellent accommodation to all students.
2. DEFINITIONS
(i) “PGMEE” means Postgraduate Medical Entrance Examination.
(ii) “Qualifying Examination” means Examinations on the result of which the
candidate becomes eligible to apply for admission to the Postgraduate Medical
Entrance Examination.
(iii) “Eligible Candidates” means a candidate who satisfies the requirement of
eligibility as prescribed by M.C.I.
3. BAN ON RAGGING
The Campus of the University is ragging free.
Definition : Ragging means causing, inducing, compelling or forcing a student
whether by way of a practical joke or otherwise to do any act which detracts from
human dignity or violates his person or exposes him to ridicule or to forbear from
doing any lawful act by intimidating, wrongfully restraining, wrongfully containing
or injuring him or by using criminal force on him or by holding out to him any
threat of such intimidation, wrongful restraint, wrongful confinement, injury or the
use of criminal force. Supreme court of India has defined ragging as a criminal
offence.2
Penalty for ragging (Section, 116 of the Act)
1. No person who is a student in an educational institution, including an
institution under the management of the university or the central government
shall commit or abet ragging.
2. Any person who indulges in or abets ragging shall on conviction be punished
with imprisonment for a term which may extend to one year. Ragging is a
criminal and non-bailable offence.
Warning :
No leniency will be shown to the offenders involved in ragging. All
students are requested to note and co-operate in keeping our
University and its constituent colleges free from ragging.
4. COURSES OFFERED WITH SEATS AVAILABLE
MD PROGRAMS
Srl. No. Subject No. of Seats Duration
1. Anesthesiology 03
2. Anatomy 03
3. Biochemistry 03
4. Community Medicine 03
5. General Medicine 10
6. Microbiology 03
7. Paediatrics 03
8. Pathology 04
9. Pharmacology 03
10. Physiology 04
11. Radio-diagnosis 03
Total Seats : 42
Three years from the
date of admission.
However, exemption of
one year shall be
granted to students
having a recognized two
years postgraduate
diploma in the same
subject.
MS PROGRAMS
Srl. No. Subject No. of Seats Duration
1. E.N.T. 02
2. General Surgery 08
3. Obst. & Gynae. 04
4. Ophthalmology 04
5. Orthopedics 04
Total Seats : 22
Three years from the
date of admission.
However, exemption of
one year shall be
granted to students
having a recognized two
years postgraduate
diploma in the same
subject.
3
DIPLOMA PROGRAMS
Srl.
No.
Subject
No. of
Seats
Duration
1. Diploma in Anesthesiology (D.A.) 03
2. Diploma in Child Health (D.C.H.) 02
3. Diploma in Clinical Pathology (D.C.P.) 03
4. Diploma in Obst. & Gynae. (D.G.O.) 02
5. Diploma in Orthopedics (D. Ortho.) 02
6. Diploma in Medical Radio-diagnosis (D.M.R.D.) 03
Total Seats : 15
Two years
from the
date of
admission.
5. ELIGIBILITY CRITERIA
(i) A candidate, who holds MBBS degree or an equivalent qualification and who
has obtained permanent registration with the Medical Council of India (MCI) or
any of the State Medical Council(s) after completing compulsory rotating
internship shall be eligible to take this examination.
(ii) However, a candidate who after passing the final qualifying examination (MBBS
or equivalent examination), is undergoing 12 month compulsory rotating
internship and is likely to complete the same by 31st
March, 2012 can take up
this examination. The candidate must produce a certificate from the head of
institution that he/she will be completing internship by 31st
March, 2012. But
he/she will not be eligible for admission unless he/she has completed the
compulsory rotating internship on or before 31st
March, 2012. They have to
obtain permanent MCI registration before joining the course.
6. PATTERN & SYLLABUS OF PGMEE – 2012
(i) There will be one paper of 3 (three) hours duration containing 250 Multiple
Choice Questions consisting of all the subjects of MBBS curriculum.
(ii) The questions will be single response objective type.
(iii) The tentative number of questions from each subject will be as given below:-
Anatomy (10), Physiology (10), Biochemistry (10), Pharmacology (10), Pathology
(15), Microbiology (10), Forensic Medicine (10), Social and Preventive Medicine
(15), Ophthalmology (10), ENT (10), Medicine & allied (50), Surgery & allied
(50), Obst & Gynae (30) and Paediatrics (10).
(iv) The examination will be conducted in English medium only.
7. SCHEDULE OF PGMEE – 2012
The Postgraduate Medical Entrance Examination – 2012 will be held on :
• Date : February 19th 2012 (Sunday)
• Time: 10:00 A.M. to 01:00 P.M. 4
8. CENTRE FOR PGMEE – 2012
The Postgraduate Medical Entrance Examination – 2012 will be held in New
Delhi. The centres (at New Delhi) will be conveyed to the candidate through the
Admit card for PGMEE – 2012.
The Candidate must make his/her own arrangements to reach the Examination
centres well in advance.
9. INSTRUCTIONS FOR COMPLETING & SENDING THE APPLICATION FORM
(i) A candidate seeking admission to the Entrance Examination is required to send
his/her application in the prescribed format which can be downloaded from our
website www.hihtuniversity.edu.in.
(ii) The candidate should fill in the application form in his/her own handwriting (in
capital letters) clearly and legibly.
(iii) Furnishing of false information or suppression of material information in the
application form will entail disqualification and shall render the candidate unfit
for admission. If ineligibility is detected at any stage, the
candidature/admission will be treated as cancelled and no further
correspondence in this regard will be entertained. Further, the intimation in
this regard will be sent to M.C.I. and concerned medical college for necessary
action.
(iv) Incomplete application form will be rejected and no correspondence will be
entertained by the University in this regard.
(v) It will be the responsibility of the candidate to ensure that the correct address
is filled in the Application Form. The University shall not be responsible for
any loss in transit or for incorrect address given by the applicant in the
Application Form.
(vi) A candidate should not submit more than one application.
(vii) Since allotment of seats is made through counseling, candidates don’t have to
give their choice of subject at the time of submission of application form.
(viii)The application form must be accompanied with self attested photocopies
of the following documents :
(i) Date of birth certificate or High School certificate containing date of birth.
(ii) Mark sheets of MBBS examinations (all professional examinations).
(iii) MBBS degree or Provisional passing certificate.
(iv) Internship completion certificate or certificate from the head of the
institution that the candidate will be completing the internship by
31st
March 2012.
(v) Permanent/Provisional registration certificate issued by M.C.I./State
Medical Council.
(vi) Two self addressed registered envelopes.
(vii) Two recent passport size colored photographs (photographs should be
same as affixed on the application form and the admit card).
(ix) Application form complete in all respect along with a Demand draft of ` 2000/-
(rupees two thousand only) should be sent to the Controller of Examinations,
HIHT University, Swami Ram Nagar, Doiwala, Dehradun 248140
(Uttarakhand) by speed post/registered post or deposited by hand at the office
of the Controller of Examinations. Application received after the prescribed last
date shall be rejected. 5
(x) Demand Draft should be drawn in favour of HIHT University payable at
State Bank of India, Jolly Grant (Branch code No- 10580), Dehradun.
(xi) Photograph :
Two recent high contrast clear passport size colored photographs are required.
Polaroid photographs are NOT acceptable.
(i) Photographs must be snapped on or after 01-09-2011.
Photograph must be taken with the name of the candidate
(as in application) and date of taking phototograph (as per
the sample given)
(SAMPLE)
(ii) The name & date on the photograph must be clear and legible.
(iii) Applicants should not wear any cap, goggles, while being photographed.
(iv) One photograph should be pasted (NOT stapled) on the Application Form
and the other on the Admit Card.
(v) The photograph on the Application Form must be attested by a Gazetted
Officer/Principal with a legible stamp. The photograph on the Admit Card
is NOT to be attested.
(vi) Few identical photographs should be kept in reserve.
(xii) The Candidate is required to go through the check list before sending his/her
application form (as given in Appendix – IX).
NOTE: Candidates are strongly advised not to approach any individual or
agency for admission. This University has no branches and no
individual/agency is authorized to act on its behalf. Admission to all the Post
Graduate courses is solely based on the merit list of Postgraduate Medical
Entrance Examination (PGMEE) conducted by the University.
10. ADMIT CARD
(i) In case a candidate does not receive the Admit Card by 15th
February 2012,
he/she should immediately get in touch with the Office of the Controller of
Examinations with duly attested passport size photograph and proof of sending
application form, so that Duplicate Admit Card can be issued. Last date for
issue of duplicate admit card shall be 17th
February 2012 (04:00 pm).
(ii) The University bears no responsibility for non-receipt of Admit Card due to loss
in transit or on any other ground. Efforts to procure the duplicate admit card,
from office of the Controller of Examinations, is the sole responsibility of the
candidate.
(iii) Candidates are advised to preserve their Admit Card till allotment of seat.
Duplicate Admit Card will not be issued after the examination. 6
(iv) No candidate will be allowed to enter the Examination Hall without a valid
Admit Card in original.
11. INSTRUCTIONS FOR EXAMINATION
(i) The Candidate should report at the Examination centre on Sunday, the
19th
February, 2012 at 9:30 AM. No candidate will be allowed to enter the
examination hall after 9:45 AM.
(ii) The Examination will start sharp at 10:00 AM. No candidate shall be allowed to
leave the examination hall before the expiry of the examination.
(iii) Temporary absence, during examination, for using urinal/toilet is not
permissible.
(iv) The Candidate must bring their own black ball point pen, pencils and eraser.
(v) No candidate should carry any textual material, printed or written, bits of
papers or any other material except the Admit Card (without envelope) inside
the hall. If a candidate is found to be copying/conversing with other
candidates/ to have in his/her possession papers, notes or books, he/she shall
be disqualified from taking this Examination and the next one or two such
examinations according to the nature of offence and the matter be reported to
MCI for necessary action.
(vi) Candidates shall maintain silence and attend to their papers only. Any
disturbance in examination hall shall be deemed as misconduct and the
candidate shall forfeit the right to continue to write in the examination. The
decision of the Centre superintendent shall be final and binding on candidate.
(vii) Cellular phones, pagers, calculators etc. are strictly prohibited in the
Examination hall.
(viii)In case of any unfair means, action shall be taken as per the rules of HIHT
University.
11.1 THE ANSWER SHEET
(i) The Answer Sheet will be provided with the pre-printed sealed
question booklet. Do not open / break the seal before the
announcements in the examination hall.
(Sample of the Answer sheet is given in Appendix – VIII)
(ii) The Candidates are advised to read the instructions written on the
answer sheet carefully and follow it for marking the answers.
(iii) The answer sheet used will be scanned by an Optical Scanner.
(iv) All entries are to be made with black ball point pen only.
(v) It is advisable to mark the appropriate answer with a pencil first,
so that if any correction is considered later on, it can be easily
erased. The appropriate answer should be darkened with a black
ball point pen only, when the candidate is sure about the answer.
No change in answer once marked with pen is allowed. Use of eraser
or white fluid on the Answer sheet is not permissible as the Answer
sheets are machine gradable and it may lead to wrong evaluation.
(vi) On the answer sheet, write your Name, Roll Number, and booklet
number in the boxes provided and darken the appropriate circles 7
below the boxes very carefully. (The Candidate must also sign in the
appropriate box provided for that purpose.)
For example : if the Roll no. is 2012001 and the booklet no. is 3101,
it should be filled as follows :
(Roll Number) (Booklet Number)
(vii) The Roll number and the Booklet number as filled by the candidate in
the Answer Sheet will be accepted as final for the purpose of
evaluation. When these numbers are not written or written wrongly,
the answer sheet will not be evaluated. The candidate will be solely
responsible for any error, omission in filling up the Roll Number and
the booklet number.
(viii) Each MCQ will consist of a stem which may be in the form of
a question or an incomplete statement and four responses
labeled a, b, c and d. Candidates should indicate the most
appropriate answer by darkening the appropriate circle completely
by black ball point pen only. Candidate should not indicate the
answer in any other way like tick mark, cross, dot, line etc.
(ix) Candidates are to submit question booklet also alongwith the answer
sheet at the end of examination.
11.2 MARKING SYSTEM
All questions will be objective type with four (a,b,c,d) choices of which, only
one will be the most appropriate.
For each correct response, a candidate shall be awarded four marks. One
mark will be deducted for every wrong response. Zero mark will be given for
the questions not attempted. More than one answer indicated against a
question will be considered as incorrect response and will attract one
negative mark.
8
11.3 ROUGH WORK
All rough work should be done in the blank pages provided in the end of
Question Booklet only.
12. MERIT LIST
(i) Candidates securing less than 50% marks (40% in case of SC/ST/OBC
candidates) in the entrance examination will not be considered for admission
and their names will not be included in the merit list.
(ii) In case of two or more candidates obtaining equal marks at the PGMEE – 2012
(i.e. in case of a tie) the following procedure shall be adopted for preparing the
merit list:
(a) First Level: The candidate having more marks in the final
professional MBBS examination shall get priority. If the tie still
persists then –
(b) Second Level: The candidate having higher aggregate percentage
marks in all the professional MBBS examinations taken together shall
get priority. If the tie still persists then –
(c) Third Level: Candidate who is older in age shall get priority.
13. DECLARATION OF RESULTS
The result of successful candidates only with their rank numbers & marks obtained
is expected to be declared by end of February – 2012, and will be available on our
website www.hihtuniversity.edu.in
13.1 Rules for Re-Checking /Re-Evaluation of Answer Sheets
The Computerized (OMR) Answer sheets are evaluated with extreme care and
are repeatedly scrutinized. There is no provision for re-checking/reevaluation. No correspondence in this regard will be entertained.
13.2 Legal Jurisdiction:
All disputes pertaining to the conduct of examination by the university and
allotment of seats in various subjects shall fall within the jurisdiction of
Hon’ble High Court of Nainital regarding PGMEE – 2012.
14. PRESERVATION OF RECORDS
The records of candidates (PGMEE – 2012), who are not admitted to any of the P.G.
degree/diploma courses shall be preserved only till 30th
September 2012. 9
15. INSTRUCTIONS FOR COUNSELING/ADMISSION
(i) The date of Counseling will be intimated to the successful candidates
separately and posted on the University website also. However the candidates
are required to remain in touch with the examination office to avoid any
inconvenience.
(ii) The allotment of seats shall be made to the candidates through personal
appearance and strictly on the basis of merit cum choice.
(iii) In case any candidate is unable to appear in person on the notified date
for counseling, he/she can send his/her authorized representative with an
authority and undertaking letter as given in Appendix IV and Appendix V
along with requisite original documents. The allotment made to the authorized
representative shall be binding on the candidate.
(iv) Failure to report for counseling on the scheduled date and time shall result in
cancellation of the claim of the candidate to the seat. It shall be the candidate’s
responsibility to ascertain the result of the PGMEE.
(v) The candidate appearing for allotment by personal appearance should bring the
following documents in original along with 2 sets of attested photo copies of
the same:
a. Admit Card of Post Graduate Medical Entrance Examination (PGMEE) –
2012.
b. Call Letter issued by University for counseling.
c. MBBS degree/Provisional passing certificate.
d. Mark sheets of MBBS examinations (all professional examinations).
e. Internship completion certificate/certificate from the head of the Institution
that the candidate will be completing the internship by 31st
March 2012.
f. Valid permanent/provisional registration certificate issued by MCI/State
Medical Council.
g. High School/Higher Secondary certificate in proof of age.
h. Six recent colored passport size photographs.
i. Recent Character Certificate from the head of the institution last attended/
or from a Gazetted officer.
j. Any other relevant certificate or document. e.g. – Caste certificate in case of
O.B.C./ S.C./ S.T. candidates.
k. Affidavit against ragging from Candidate & parent as per appendix- VI & VII
(Note: The above undertaking is to be given on a non – judicial notarized stamp
paper of ` ` ` 10/-)
Candidates without original documents will not be allowed to participate
in the counseling (allotment by personal appearance/authorized
representative).
(vi) The candidates will have the right to choose any one of the seats available at
the time of his/ her counseling and the same will be allotted to him/her.
(vii) Presence of candidate or his/her authorized representative for allotment of
seat, on a notified date, does not mean that a seat shall necessarily be allotted
to him/her, as the same shall depend upon the availability of a seat and the
choices exercised by the candidate or his/her authorized representative.
(viii)Allotment letter will be issued on the day of counseling to the person who
appears for counseling. 10
(ix) The candidates who do not appear for allotment in person or through an
authorized representative, on notified date, or who reject the available seats for
allotment or those who do not join the allotted course by the last date of joining
mentioned in the allotment letter, shall forfeit their claim for a seat, which shall
then be allotted to the candidate next in the merit list.
(x) Admitted candidates, must join their courses on 02.05.2012. If they do not
join, they shall forfeit their claim for a seat.
(xi) If a candidate after taking admission to the allotted course, discontinues the PG
course, or his/her admission is cancelled by the institution for any reason,
he/she shall forfeit the claim for a seat.
(xii) While reporting for admission, all the relevant certificates/documents in
original are to be submitted. These original documents shall be kept with the
institution till completion of the course.
(xiii)No oral enquiry would be entertained by the authorities. Candidates are
requested to communicate in writing. They must take special care to indicate
their rank number, roll number, name and postal address in their letter. It
should also be signed.
(xiv) Canvassing directly or indirectly for allotment of seats or adjustments
thereafter would lead to disqualification of their candidature. Influencing the
staff by unfair means would lead to serious consequences for all concerned.
The candidates or their relatives visiting University for seeking change of the
allotment would face disqualification, since such visit would be treated as
trespassing.
(xv) The authorities are not obliged to enter into any correspondence with
candidates, unless it is an absolute necessity.
11
APPENDIX – I
FEE STRUCTURE FOR MD/MS/DIPLOMA COURSES – 2012
Sl.
No.
Subject Admission
Fee (One
Time)
Tuition Fee Hostel Charges
1.
MD (Anatomy)
MD (Physiology)
MD (Biochemistry)
“` 35,000/-
“` 3,00,000/- P.A.
with progressive
increase of 10%
every year.
2.
MD (Comm. Medicine)
MD (Pharmacology)
MD (Microbiology)
D.C.P.
` ` ` 35,000/-
“` 4,00,000/- P.A.
with progressive
increase of 10%
every year.
3. MD (Pathology) “` 35,000/-
“` 7,00,000/- P.A.
with progressive
increase of 10%
every year.
MD (Gen. Medicine)
MD (Paediatrics)
MD (Radio Diagnosis)
MD (Anaesthesiology)
4. MS (Gen. Surgery)
MS (Orthopaedics)
MS (Obst. & Gynae)
MS (Ophthalmology)
MS (E.N.T.)
5.
D.A.
D.M.R.D.
D. Ortho.
D.G.O.
D.C.H.
“` 35,000/-
“` 8,00,000/- P.A.
with progressive
increase of 10%
every year.
U.G. Hostel-
“` 48,000/- P.A.
P.G. Hostel-
` ` ` 72,000/- P.A.
NOTE:
1.This fee does not include enrolment fee & mess charges and the same will be charged
separately. In case a candidate is not able to complete the course in stipulated period of
time, extra fees shall be charged.
2. The above fee structure is under consideration for revision and is likely to
change. The revised fee structure shall be available on the University website prior
to counseling. 12
APPENDIX – II
HIHT UNIVERSITY
POSTGRADUATE MEDICAL ENTRANCE EXAMINATION
MD/MS/DIPLOMA COURSES – 2012
APPLICATION FORM
1. Name of the Candidate : ———————————————————
2. Father’s Name : ———————————————————-
3. Date of Birth : ———————————————————-
4. Permanent Address : ———————————————————-
& Phone No.
———————————————————-
5. Present Address : ———————————————————-
& Phone No.
———————————————————-
6. Category
(General/SC/ST/OBC) : ———————————————————-
7. Education Qualification : (Self attested photocopy of the documents to be submitted
with the application form)
Name of Exam.
University /
Board
Subjects
Marks obtained
/Total marks
% age of
Marks
Attempts
Taken
M.B.B.S. I Prof.

M.B.B.S. II Prof.
M.B.B.S. Final
Prof. Part I

M.B.B.S. Final
Prof. Part II
8. Internship : Completed / Likely to be completed on ——————————–
(documentary proof required)
Declaration :-
I sincerely affirm that I have read all the instructions regarding the Post Graduate Medical Entrance
Examination-2012 conducted by the HIHT University. I will abide by these instructions. I also affirm that the
statement made and information furnished by me in the application form is true and correct. If however, it is
found that any information furnished here is fraudulent, incorrect or untrue, immaterial particulars, I realize
that I am liable to criminal prosecution and my selection and admission to the course is liable to be
cancelled.
Date :
Place : Candidate’s Signature & Name
Attested
photograph
(Candidate’s Left Thumb impression) 13
APPENDIX – III
HIHT UNIVERSITY
POSTGRADUATE MEDICAL ENTRANCE EXAMINATION
MD/MS/DIPLOMA COURSES – 2012
ADMIT CARD
Roll No. : ——————————————–
(to be allotted by the Institute)
Candidate’s Name : —————————————————————————
(to be filled by the candidate)
Father’s Name : —————————————————————————
(to be filled by the candidate)
Visible Mark of Identification : —————————————————————————
(to be filled by the candidate)
E mail Address : —————————————————————————
Date & Time of Examination : 19
th
February 2012, (10:00 AM to 01:00 PM)
Centre of Examination :
(For official use only)

Candidate’s Left Thumb Impression Signature of Candidate

—————————————–
(Controller of Examinations)
Candidate’s Signature
on the day of Examination —————————-
Signature of Invigilator
With Name & Date —————————————
NOTE: No entry after 9:45 AM.
Photograph
(Not to be attested) 14
APPENDIX – IV
HIHT UNIVERSITY
(Under Section 3 of UGC Act 1956)
POSTGRADUATE MEDICAL ENTRANCE EXAMINATION
MD/MS/DIPLOMA COURSES – 2012
AUTHORITY LETTER
I, Dr.——————————————————————————- son / daughter / wife of Dr./ Mr. –
——————————————————— bearing Roll no. ————————– placed at Rank
no. ——————— for Postgraduate Medical Entrance Examination-2012 for admission into MD/
MS/Diploma courses, do hereby authorize Mr./Ms./—————————————————–, son /
daughter / wife of Dr. / Mr. —————————————————————————————-, R/o
————————————————————————————————————————–to
represent me on ———————– (date) before the committee for allotment of seat in MD / MS /
Diploma courses. The signatures and the photograph of above named Mr. / Ms, ————————
————————————— are attested below.
___________________
Signature of Candidate
Date:……………………
Name : ___________________________
Roll no.: ____________ Rank __________

Address : ___________________________
___________________________
______________________________
Signature of authorized representative
Date:……………………
Photograph of the
candidate attested by
Gazzeted officer
Photograph of the
representative
attested by the
candidate 15
APPENDIX – V
HIHT UNIVERSITY
(Under Section 3 of UGC Act 1956)
POSTGRADUATE MEDICAL ENTRANCE EXAMINATION
MD/MS/DIPLOMA COURSES – 2012
UNDERTAKING REGARDING AUTHORIZATION
I, Dr. —————————————————————————————— son / daughter / wife of

Dr. / Mr. ——————————————————- aged about ——————years bearing Roll.
no. —————————– placed at rank no. ——————– in Postgraduate Medical Entrance
Examination- 2012 for admission into MD / MS / Diploma courses, do hereby solemnly affirm and
undertake that the decision of my authorized representative, Mr./Ms/ —————————————
——————————————— son / daughter / wife of Dr. / Mr. ——————————————
—– aged about ——————— years regarding selection / rejection of the seat on the date of
personal appearance shall be binding on me and I shall not have any claim whatsoever, other than
the decision taken by my authorized representative on my behalf on —————–.
___________________ _________________________

Signature of Candidate Signature of authorized person
Date:…………………… Date:……………………

Name : —————————————–
Roll no. : —————————————–
Rank : —————————————–
Address : —————————————–
—————————————– 16
APPENDIX – VI
AFFIDAVIT BY THE STUDENT
Before the Dean, Himalayan Institute of Medical Sciences, HIHT University,
Swami Ram Nagar, Doiwala, Dehradun.
1. I, Dr.______________________________________________ ______(full name of student)
S/o/D/oMr./Mrs. ___________________________________________, having been admitted to
Himalayan Institute of Medical Sciences, have seen a copy of the UGC Regulations on Curbing
the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called the
“Regulations”) carefully read and fully understood the provisions contained in the said
regulations.
2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes
ragging.
3. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully
aware of the penal and administrative action that is liable to be taken against me in case I am
found guilty of or abetting ragging, actively or passively, or being part of a conspiracy to promote
ragging.
4. I hereby solemnly aver and undertake that
a. I will not indulge in any behaviour or act that may be constituted as ragging under clause 3
of the Regulations.
b. I will not participate in or abet or propagate through any act of commission or omission that
may be constituted as ragging under clause 3 of the Regulations.
5. I hereby affirm that, if found guilty of ragging, I am liable for punishment according to clause 9.1
of the Regulations, without prejudice to any other criminal action that may be taken against me
under any penal law or any law for the time being in force.
6. I hereby declare that I have not been expelled or debarred from admission in any institution in
the country on account of being found guilty of, abetting or being part of a conspiracy to
promote, ragging; and further affirm that, in case the declaration is found to be untrue, I am
aware that my admission is liable to be cancelled.
Declare this _____ day of _________month of ________year.

Signature of deponent
Name:
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the
affidavit is false and nothing has been concealed or misstated therein.
Verified at __________ (place) on this ______ (day) of ______ (month) _________ (year).
Signature of deponent
Solemnly affirmed and signed in my presence on this the _________ (day) of ____ (month),
_____ (year) after reading the contents of this affidavit.
NOTARY17
APPENDIX – VII
AFFIDAVIT BY PARENT/GUARDIAN
Before the Dean, Himalayan Institute of Medical Sciences, HIHT University,
Swami Ram Nagar, Doiwala, Dehradun.
1. I, Mr./Mrs.____________________________________________(full name of parent/guardian)
father/mother/guardian of, Dr.__________________________________________(full name of
student) having been admitted to Himalayan Institute of Medical Sciences, have seen a copy of
the UGC regulations on curbing the menace of ragging in higher educational institutions, 2009,
(hereinafter called the “ Regulations”), carefully read and fully understood the provisions
contained in the said regulations.
2. I have, in particular, perused clause 3 of the regulations and am aware as to what constitutes
ragging.
3. I have also, in particular, perused clause 7 and clause 9.1 of the regulations and am fully aware
of the penal and administrative action that is liable to be taken against my ward in case he /she
is found guilty of or abetting ragging, actively or passively, or being part of a conspiracy to
promote ragging.
4. I hereby solemnly aver and undertake that
a. My ward will not indulge in any behaviour or act that may be constituted as ragging under
clause 3 of the regulations
b. My ward will not participate in or abet or propagate through any act of commission or
omission that may be constituted as ragging under clause 3 of the regulations.
5. I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to
clause 9.1 of the regulations, without prejudice to any other criminal action that may be taken
against my ward under any penal law or any law for the time being in force.
6. I hereby declare that my ward has not been expelled or debarred from admission in any
institution in the country on account of being found guilty of, abetting or being part of a
conspiracy to promote, ragging; and further affirm that, in case the declaration is found to be
untrue, the admission of my ward is liable to be cancelled
Declared this_________ day of _______ month of ___________ year.
Signature of deponent
Name:
Address:
Telephone/Mobile No.:
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the
affidavit is false and nothing has been concealed or misstated therein.
Verified at _______ (place) on this the ______ (day) of ______ (month) ________(year)
Signature of deponent
Solemnly affirmed and signed in my presence on this the _____ (day) of _______ (month)
________(year) after reading the contents of this affidavit.
NOTARY 18
APPENDIX – VIII (SIDE-1) 19
APPENDIX – VIII (SIDE-2) 20
APPENDIX – IX
POSTGRADUATE MEDICAL ENTRANCE EXAMINATION – 2012
CHECKLIST
Before sending your application set for PGMEE – 2012, make sure it is
comprised of all the necessary documents, in the following order
(as given below) :
Srl.No. Documents
1.
Demand Draft of “` 2000/- (rupees two thousand only) should be drawn
in favour of HIHT University payable at State Bank of India, Jolly Grant
(Branch code No- 10580), Dehradun.
2. Completely filled – Application Form for PGMEE – 2012.
3.
Self attested photocopy of Date of birth certificate or High School
certificate containing date of birth.
4.
Self attested photocopy of Mark sheets of MBBS examinations (all
professional examinations).
5.
Self attested photocopy of MBBS degree or Provisional passing
certificate.
6.
Self attested photocopy of Internship completion certificate / certificate
from the head of the Institution that the candidate will be completing the
internship by 31st
March 2012.
7.
Self attested photocopy of Permanent/Provisional registration certificate
issued by M.C.I./State Medical Council.
8. Two self addressed registered envelopes.
9.
Two recent passport size colored photographs (photographs should be
same as affixed on the application form and the admit card).

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