SETH G. S.

MEDICAL COLLEGE, PAREL, MUMBAI - 12

M. B. B. S. ADMISSION 2022-2023
MUHS Eligibility Section, Nashik AIR NO_____

Kum/Kumari. ___________________________________________, Selected

under category _______Sub Caste____________ has submitted following ORIGINAL
certificates with FOUR (04) sets of Attested photo copies with admission form duly
filled in the file.

(A)Group
01) Selection Letter /Allotment Letter
02) Nationality Certificate OR Valid Passport
03) Domicile Certificate
04) S. S. C. Passing Certificate (10th Std.)
05) 12th H.S.C. Mark sheet
06) NEET Exam Mark sheet (2022)
07) NEET Admit Card
08) NEET Application Form
09) Cast Certificate OR EWS Certificate
10) Caste Validity Certificate (If your state do not issue CVC, you have to submit the
letter from Competent Authority as per attached proforma)
11) Non Creamy Layer Certificate (For NT – 1,2,3 VJ & OBC)
12) College Leaving OR Transfer Certificate
13) Physical Handicap Certificates
14) Defense Certificate (D1 & D2 – Parent’s Maharashtra Domicile required)
15) Hilly Area Certificate (Parent’s Domicile in hilly area required &SSC/HSC School
should be situated in Hilly Area)

(B) Group
01) Report of Blood (Hemogram)
02) Physical Fitness Certificate
03) Migration Certificate (If HSC Board is other than Maharashtra Board)
04) Self Educational Gap certificate (Affidavit from students)
05) Aadhar Card Copy
06) Two Xerox copies of Demand DraftDate :

Student’s Signature________________

Clerk (GUG) H.C. (GUG)

 UNDERTAKING

Name ___________________________
AIR No.______ Category _____
To,
The Dean
Seth G. S. Medical College
Parel, Mumbai – 400012

Subject: M.B.B.S. admission at Seth G. S. Medical College during the

academic year 2022-2023

Sir/Madam,

I hereby agree to confirm the rules and regulations at present in force or hereafter be
made for the Administration of the College, I will do nothing unworthy of the student of the college
either inside or outside or anything that will interfere with its orderly working and I have carefully read
and understood criteria for eligibility for University Examination i.e. i) 75% attendance in Lectures &
80% attendance in non-Lecture teaching programme, ii) Minimum of 50% score in the internal
assessment in theory and practical taken together.
I do hereby undertake to comply with the above-mentioned criteria and have noted that
if I fail to fulfill the requirements as above, my form of application for admission to the University
Examinations will not be accepted and I will not be sent up for the University Examinations. I will
submit the Service agreement and surety bond as per rule for his/her admission year 2022-
2023 within one month from the date of issuing the form.
Subsequent to admission & payment of fees for First term, I have to pay fees and
other dues every term per notification. I have noted that, I have to keep valid Identity Card with me
during College hours including examination time and should be produced whenever required by
college authority.
I have noted that, I will not allow filling the University examination form if I fail to pay the
fees as per notification. I undertake that, I will fill up B.C. freeship/scholarship form every year i.e.
June/July or immediately after result as the case may be. I have noted that I will be required to pay
college tuition fees and other charges as per schedule with fine. I have noted that no individual
intimation/letter will be send in this regard.
I have kept sufficient number of certified copies of all original certificates for my use for
5 & 1/2 years, as original certificates are kept in the Nashik University office till completion of the
Surety Bond.
The present fees are under revision and I have noted that I will have to pay the fees
and other charges as per revised rate from the academic year 2022-2023 subsequent to revision.
I am completely aware that if I will cancel my admission after the Cut-off date, I
have to pay the Bond Amount (Rs.10,00,000/-), entire course fees, and the amount of Security
Deposit of Rs. 4000/- shall be forfeited by the Corporation.
I am completely aware that after completion of internship I have to compulsory
serve the Government of Maharashtra for the period of one year. Further, candidate cannot go
abroad up to Five years from the date of obtaining the MBBS Degree, otherwise he/she will
have to pay Non Refundable Rs. 10,00,000/- as penalty.

Name of the Father/Mother/Guardian

_____________________________
Signature _____________________
Address ______________________ Signature of the candidate
_____________________________
Mobile No_____________________
 SETH G. S. MEDICAL COLLEGE, PAREL, MUMBAI-12.
GUIDELINES FOR THE STUDENTS, WHO HAVE SEEKING THE ADMISSION AT SETH
G.S.M. COLLEGE FOR FIRST YEAR M.B.B.S. FOR THE ACADEMIC YEAR 2022-2023

Please follow the steps in order to complete admission procedure.

1) Submit one photocopy of the selection letter at UG Section.

2) Register your details in the register at UG Section
3) Collect photocopy of the selection letter from UG Section duly stamped for
collection of Admission form which is available on Cash Counter of College Office
between 11.00 a.m. to 3.30 p.m. on Monday to Friday except holidays.
4) Fill up the B.C. free ship form at Counter No.1 of GTR Section, Room No 13, Gr
Floor, College Bldg. (For reserve category students only)
5) Arrange following original and attested Xerox copies of four set of each
certificates/documents in following sequences in the College file.
(A) Group

01) Selection Letter /Allotment Letter

02) Nationality Certificate/ OR Valid Passport
03) Domicile Certificate
04) S. S. C. Passing Certificate (10th Std.)
05) 12th H.S.C. Mark sheet
06) NEET Exam Mark sheet (2022)
07) NEET Admit Card
08) NEET Application Form
09) Cast Certificate OR EWS Certificate
10) Caste Validity Certificate (If your state do not issue CVC, you have to submit the
letter from Competent Authority as per attached proforma)
11) Non Creamy Layer Certificate (For NT – 1,2,3 VJ & OBC)
12) College Leaving OR Transfer Certificate
13) Physical Handicap Certificates
14) Defence Certificate (D1 & D2 – Parent’s Maharashtra Domicile required)
15) Hilly Area Certificate (Parent’s Domicile in hilly area required &SSC/HSC School
should be situated in Hilly Area)
(B)Group
01) Report of Blood (Hemogram)
02) Physical Fitness Certificate
03) Migration Certificate (If HSC Board is other than Maharashtra Board)
04) Self Educational Gap certificate (Affidavit from students)
05) Aadhar Card Copy
Submit College file and get the same verified from UG Section.

Please collect the payment slip for payment of fees from UG Section

Notice : Fees will be accepted at cash section of the college office subject to
provisional eligibility from the Registrar, Maharashtra University Of Health Sciences
Nashik and without prejudice to final court order in case admission is related to writ
petition where in interim court order are issued and subject to submission of
agreement bond within One Month from the date of issue.

Students have to submit scanned copies of all the Original

documents mentioned above including Fitness, Hemogram,
Voter ID Form (Annex C) & Demand Draft of MBBS TOTAL
Fees, in separate folder with student name. Each document
should be labelled separately like Allotment Letter,
Nationality certificate, Xth Passing , XIIth Mark sheet etc. (
file size of documents should be 50 kb To 150 kb in PDF
format) on pen drive and send all the PDF Files on email
(write your name in the subject) : [email protected]
(Kindly note this email address is only for the sending PDF
Files of the selected MBBS candidates. Please do not make
any other enquiry on this mail.

Late fees of Rs. 500/- per day will be charged from the candidate
towards the late submission of Registration and Eligibility form.
(As per MUHS Rules)
 DETAILS OF THE FEES.

Seth G. S. Medical College Parel Mumbai 12

Fee Structure of I st M.B.B.S. for

the year 2022-2023
Sr. No. Particular Category Reserve S.C. EWS
Open Category Category
(ST,OBC,VJ
& NT)
1 Tuition Fees 1,23,200/- 6, 400/- 1, 400/- 66,050/-

2 Deposit 4,000/- 4, 000/- 4, 000/- 4, 000/-

3 Gymkhana Fees 2,950/- 2,950/- 2,950/- 2,950/-

4 University Fees 2,900/- 2,900/- 2,900/- 2,900/-

1,33,050/- **16,250/- **11,250/ **75,900/-

Total -

Total Fees are paid in Single D.D. only in favour of Dean, Seth G.
S. Medical College Payable at Mumbai
**The Condition for availing Freeship is the student should be a domicile of
Maharashtra State only and he/she has to produce the Caste Certificate & Caste
Validity Certificate issued by the Government of Maharashtra. For the students from
other states they can avail the freeship from those particular states. The EWS
Students must have to fill Form of Rajarshi Chatrapati Shahu Maharaj Scholarship
otherwise they have to pay the full fees.
 1) Submit 2 photocopies of payment receipt at UG Section.

2) Collect the service Agreement & Surety Bond from UG Section

3) Submit NTS & NMS forms after admission along with sanction letter to at GTR
Section. All reserve category& EWS students shall meet at GTR Section for
Scholarship/Freeship. (Student can apply only for one Scholarship in a year. If any
student found guilty for applying more than one scholarship, strictly action will be
taken against him/her)

TEACHING PROGRAMME

For further details on teaching programme/registration no. candidates are directed to

report to the Anatomy department, 2ndfloor of this college.

HOSTEL FACILITIES FOR BOYS AND GIRLS

HOSTEL FACILITY IS NOT AVAILABLE FOR THE YEAR 2022-2023

1. There is no Particular mess fee for the students

2. Six passport size colour photographs and two copies of Admission

fee Demand Draft is required at the time of admission.

3. Only One Parent (Mother or Father) is allowed to come in the College

along with the candidate, at the time of admission.
 BOND

Students are requested to go through the instruction carefully before filling the
SURETY BOND AND THE SERVICE AGREEMENT. The students seeking the admission
for the year 2022-2023, have to execute the Service Agreement / Surety Bond Submit
the Following documents along with agreement bond in respect of sureties.

1) Copy of Income Tax Returns stating that income is more than Five
Lakh.(Financial Year 2021-22 and Assessment year 2022-23)

2) Original Service Certificate.

3) Copy of Pan Card.

4) Photocopy of the Telephone Bill/Electricity Bill/Aadhar Card etc. for residential

proof.

5) Recent passport size Photograph of the Sureties.

IDENTITY CARD

Identity card will be issued only after completion of all admission formalities including
submission of Service Agreement Bond & Surety Bond with all requisite documents and
payment of fees.

H.C.- GUG Section

Contact No.: 2410 7434

 SETH G. S. MEDICAL COLLEGE, PAREL, MUMBAI – 12

NOTICE
Ist M.B.B.S. students have to fill and submit the Service Agreement and Surety
Bond at U.G. Section, for the academic year 2022-2023.The Service Agreement and
Surety Bond will be available at UG Section The students have to fill and submit the
same on UG Section on or before one month from seeking the Ist M.B.B.S.
admission without fail. Please may be noted by the students and guardians, if
the student had failed to do so, he/she will not be allowed to attend the
examination.

INFORMATION FOR FILLING THE S.A.B. FORM

1) Before filling the Service Agreement and Surety Bond Franking should be done
from any Nationalized Bank within Mumbai Jurisdiction

2) Surety : - Agreement Bond should be filled by 2 sureties, whose yearly income is

more than Five lakh rupees. The details of 2 sureties :-
(a) At least single parent (either father or mother) will have to give the surety to the
student/s and other surety may be a relative, family friend or neighbour or any
else whose income is more than Five lakh.
(b) If both parents (father and mother both) income is less than Rs.5,00,000/- in
that case, two other persons (may be relative, family friend or neighbour) whose
yearly income is Rs.5,00,000/- are only liable to give the surety to the student/s.
(c) Witness can be any person knowing the student/s.

The attested Xerox copies of the following documents of the sureties are
required to submit with Service Agreement and Surety Bond.

1) PAN Card
2) One Recent Photograph
3) Aadhar Card/Electricity Bill/Telephone Bill
4) Income Tax Return Form (16 Number) for the income year 2021-22 and
Assessment year 2022-23.
5) Original Service Certificate
 STUDENT’S
PHOTOGRAPH

STUDENT’S PROFILE
(KINDLY FILL THE FORM IN THE CAPITAL LETTERS ONLY)
QUOTA: STATE/ALL INDIA____________
SEX; M/F___________ DATE OF ADMISSION___________
NEET ROLL NO.______________________ AIR NO______________
NAME OF THE STUDENT (in English)__________________________________________
(AS PER HSC MARKSHEET)
NAME OF THE STUDENT (in Marathi)__________________________________________
LOCAL ADDRESS__________________________________________________________
___________________________________________________PIN:____________________
PERMANENT ADDRESS_____________________________________________________
___________________________________________________PIN:_____________________
DATE OF BIRTH_________________PLACE OF BIRTH_______________
DOMICILE STATE_________________-
MOBILE NOS:- SELF____________________& FATHER/MOTHER__________________
LAND LINE NO___________________AADHAR CARD NO._______________________
BLODD GROUP___________MOTHER TOUNGE_________________
S.S.C.PASSING MARKS/OUT OF ________PERCENTAGE_______BOARD NAME__________
SCHOOL NAME____________________________MONTH &YEAR OF PASSING____________
H.S. C, PASSING MARKS/OUT OF ________PERCENTAGE_______BOARD NAME__________
COLLEGE NAME______________________________MONTH & YEAR OF PASSING_________
MARKS : PHYSICS :________ CHEM:__________ BIO:____________ ENG:__________
PCB TOTAL:______PCBE TOTAL :________PCB PERCENTAGE________HSC SEAT NO_______
NEET MARKS__________NEET PERCENTAGE____________NEET PERCENTILE ___________
ADMITTED CATEGORY/QUOTA____________STUDENT’S CATEGORY______________
SUB CASTE______________(ALSO FOR OPEN CANDIDATES), SPL RESERVATION___________
ANNUAL INCOME: FATHER__________________ MOTHER________________
SIGNATURE:: CANDIDATE____________________FATHER___________________
EMAIL ID : (IN CAPITAL)_____________________________MOTHER NAME____________
NON CREAMY LAYER VALID UPTO______________________
KINDLY ATTACHED COPY OF HSC MARKSHEET, SELECTION LETTER AND CC ,CVC & EWS
 OFFICE THE __________________________________

_________________________________

Outward No:- Date :-

TO WHOME IT MAY CONCERN

CERTIFICATE

This is to certify that, the Caste Certificate No. _____________________________________

Dated _________________________ issued to Mr./ Miss. _____________________________

By the Tahsildar / Magistrate / ______________________________________________ is Valid.

Further, it is stated that there is no provision of issuing separate Caste Validity

Certificate in ____________________________________________ State.

Office Seal / Stamp Signature of Tahsildar/ Magistrate/ Issuing Authority

 ANNEXURE – “M”

CERTIFICATE OF MEDICAL FITNESS

This is to certify that I have conducted clinical examination of Dr.

.................................................................................................. who is desirous of
admission to Medical Undergraduate Courses.
He/she has not given any personal history of any disease incapacitating him/her
to undergo the professional course. Also, on clinical examination it has been found that he/she
is medically fit to undergo the medical Undergraduate course (NEET-UG 2022 ).
(1) Absence of any incapacitating and /or progressive systematic disease/disorder / condition,
(2) Absence of any disability of upper limb/s,

(3) Absence of any major visual/auditory disability,

(4) Absence of psychosis/neurosis/mental retardation,

(5) Ability to maintain erect posture,

(6) Reasonable manual dexterity.

Address of the Registered Medical Practitioner Signature

Name

Registration No.

Seal of Registered Medical Practitioner

Date

Note:

A candidate must be medically fit to undergo the Medical Undergraduate Courses (NEET-UG 2022) applied
for. The medical fitness must be certified by a Registered Medical Practitioner in the prescribed Proforma,
as given above on a Letterhead.