West Bengal Nursing Council, Govt. of West Bengal

Registration Year * Registration Number *
Date of Birth *
Nurse Personal Details
Applicant Name * Date of Birth *
Father Name * Husband Name
Birth Place * Marital Status *
Gender * Registration Number *
Registration Date * Valid upto
Nationality * Caste *
Permanent Address
Address * Post Office *
Police Station * State *
District * Pin *
Present Address
Address * Post Office *
Police Station * State *
District * Pin *
Email ID: * Mobile No *
Professional Qualification *
Where Employed * Is Reciprocal label info *
Professional misconduct * Mention Reason
(If yes)

Select Reg. Certificate
*

Select Photo Upload
(.jpg, .jpeg, .png)


Select Signature Upload
(.jpg, .jpeg, .png)

Approval Status Reason