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Application form nursing licence exam
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Application form nursing licence exam

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  • 1. Examination CommitteeNepal Nursing CouncilDhumbarahi, KathmanduAPPLICATION FORM FOR NATIONAL LICENSURE EXAMINATION FOR NURSES (NLEN)Please fill up in CAPITAL LETTER in English or Type.A. PERSONAL INFORAMTION1. Full name of Applicant:2. Father’s name:3. Mother’s name:4. Nationality:5. Date of Birth: / /Day Month Year6. Completed age: year7. Permanent Address:District ZoneVDC / Municipality Ward No.8. Temporary Address:Telephone number: (Home) (Mobile)E-mail address (if available):AffixapplicantphotoB. PROFESSIONAL EDUCATION1. Name of Nursing School / Institute:2. Address:3.Telephone number:4.Type of Program(Give tick  into the box  or specify it.) Proficiency Certificate Level of nursing (P.C.L.) in Nepal Bachelor Science in Nursing (B.Sc. N.)in Nepal Other: (country)(program)Date of Entry: / /Day Month YearDate of Graduation: / /Day Month YearReceived by:Name of NNC Staff : Signature of applicant:Date : Date :Note: Attach the documents as prescribed in Test Guideline (NLEN)

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