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Dr. Ajit Gajanan Pathak
W.fi ) M.B.B.S ., M.D. (Forensic Medicine)
Tftarr ftqTfi Controller of Examinations
Ref. No. : MUHS/XA/9427 l2O2L Date: 24112/2O2L

Notilication No. 42 I 2O2L

coNtrocATroN 20.22
The 2lttr Convocation Ceremony of Maharashtra University of Health
st

Sciences, Nashik will be held on OTth February 2022. Successful candidates of the
following courses will be awarded the Degree Certificates / Diploma Certificates in
this Convocation Ceremony.

1 M.B.B.S. Summer 2O2O

2 B.D.S. Summer 2O2O
3 B.A.M.S. Summer 2O2O
+ B.U.M.S. Summer 2O2O
5 B.H.M.S. Summer 2O2O
6 B.A.S.L.P. Summer 2O2O
7 B.P.O. Winter 2O2O
8 B.P.T.H. Winter 2O2O
9 B.O.T.H. Winter 2O2O
10. Basic B.Sc. (Nursing) Summer 2O2L
11. P.B.B.Sc. (Nursing) Summer 2O2L
12. B.Sc. in Paramedical Technolory Summer 2O2O
L4. M.D. (Medical) Summer 2O2L
15. M.S. (Medical) Summer 2021
16. D.M. (Medical) Summer 2O2l
L7. M.Ch. (Medical) Summer 2O2L
18. M.Sc. (Medical Biochemistry) Summer 2O2L
19. PG Diploma (Atl) Summer 2O2L
20 D. M. L. T. Summer 2O2L
21. Diploma in Optometry Summer 2O2L
22. B.Sc. in Optometry Winter 2O2O
23. Diploma in Ophthalmic Science Summer 2O2L
-1
24. Diploma in Para Medical Summer 2O2L OV

25. M.D.S. & P.G.'Diploma Dental summer 2o2L {#-{ fg

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 26 M.D. (Anr rveda) & P.G. Aytrr" Diploma Sr.rmmer 2O2L
27" M.S" (Ayurweda) Summer 2O2L
28" M.D. (Unani) Summer 2O2l
29 M.S. (Unani) Summer 2O2L
30. M.D. (Homoeopathy) Sumrner 2O2L
31. M.P.Th. / M.P.T. Summer 2O2L
32 M.O.Th. Summer 2021.
33. M.Sc. (Nursing) Summer 2O2L
34 M.A.S.L.P. / M.Sc. S.L.p. Summer 2O2L
35. M.P.O. Summer 2O2L
36. M.Sc. (Pharmaceu tical Medicine) Summer 2O2L
37. M.B.A. Summer 2021.
38. M.P.H. Summer 2O2l
39. M.Phil. Winter 2O2O
Summer 2O2L
40. Ph. D. Year 2021 & result declared
before date of Convocation
4L. All Certifi cate / Fellowship Courses Summer 2O2I
Students of earlier
courses and batches covered during last, i.e. 21t,-
convocation ceremony can apply only in absentia. Degree certificates
Certificates of all ttre candidates, 'who opt to receive their Degree
/ Diploma
Certilicates /
Diploma Certificates in absentia, wilt be sent to their respective
colleges. However,
students covered under the above mentioned courses cErn apply for
receiving the
Degree Certificate / Diploma Certificate either in person or
in absentia. No change
in mode of receipt of Degree Certificate / Diploma Certificates will be permitted
once opted.
Please note that, printed Application Form will not be avaitabte
offline.
Eligible candidate shall download the Application Form and take printout
a of
it, which is displayed alonglvith this Notification. Application, duly completed in all
respect, should reach to the controller of Examinations on or before
o3/o tl2o22.
If the application form is received after this date, Degree Certificate / Diploma
Certificate will be issued after Convocation Ceremony as per due proced.ure.
It is further informed that, those candidates who fail to submit their
application within stipulated time period and application received
at a later date
will attract late fee charges mentioned in University Circular dated
2L/OS/2oL4.

@A{ \\bt
(Dr. Ajit Gajanan pathakl ,
Controller of Examinations
Place :- Nashik
Copy to: All Examination Departments. \)pire OS

E
Ct>
 egkjk"V! vkjksX; foKku fo|kihB] ukf'Ad
MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK
fnaMksjh jksM] EgljQG] ukf'kd&422004] Dindori Road, Mhasrul, Nashik-422004
Email:coe@muhs.ac.in, examadmin@muhs.ac.in Website: www.muhs.ac.in

Tel:MBBS-0253-2539216/138, BDS-0253-2539217/261, BAMS/BUMS-0253-2539218/210,

BHMS–0253-2539225, ALLIED-0253-2539221, PG Courses-0253-2539253

Application for Degree / Diploma Certificate Affix a

photograph of
(Before filling this form, please read the instructions given at size 35mm
the end. Fill up the form in CAPITAL letters only.) x45mm duly
signed across
To, & attested by
The Registrar, Dean/
Maharashtra University of Health Science, Principal of
Nashik the concerned
college
Mandatory Enclosures
(i) Attested photo copy of Final Year Passing Certificate.
(ii) Attested photo copy of Internship Completion Certificate issued by
the University.
(iii) Attested copy of XII Std. Statement of Marks/Passing Certificate.
(iv) One additional passport size photograph.

Sir,
I hereby apply for Degree / Diploma certificate of the University at
the ensuing Convocation Ceremony, to be held in the month of . . . . . . . .
PERSONAL DETAILS
1) Applicant’s Full Name (as per XII Std. Statement of Marks or XII Std.
Passing Certificate. One block to be kept blank between two words)

2) Name in Devnagri Script (Marathi).. . . . . . . . . . . . . . . . . . . .

3) Sex: Male Female
4) Phone:. . . . . . . .Mobile:.. . . . . . . . Email Id: . . . . . . . . . .
5) Postal Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . .PIN Code . . . . . . . . .
6) College Code:. . . . . Name of College:.. . . . . . . . . . . . . . . . .
7) Course :. . . . . . .Month & Year of passing final year: .. . . . . . . .
8) University PRN. . . . . . . . . . . . Final year Seat No.:. . . . . . . .
9) Convocation Attendance Status (P -In Person, A -In Absentia)
DECLARATION BY THE CANDIDATE
I have carefully read & noted the Instructions to the applicant,
before filling up this form. I declare that the information given above is
true and correct to the best of my knowledge and belief. I undertake that I
shall be responsible and accountable for any omission/errors and
wrong/incomplete entries made by me in this form.
Place :
Date : Signature of Applicant
 INSTRUCTIONS TO THE APPLICANT
1) Incomplete forms and forms without attested photo copies of Final Year
Passing Certificate, Internship Completion Certificate issued by the
University and XII Std Statement of Marks or Passing Certificate and
additional passport size photograph, will not be accepted.
2) The acknowledgment of this form should be preserved carefully and
produced at the time of collection of the Degree/Diploma Certificate on the
day of the Convocation Ceremony, or as and when the Degree/Diploma
Certificate is collected.
3) Any complaint, regarding non-receipt of Degree/Diploma Certificate, (viz.
Name, College, Class, Subject, Final Year of Passing, etc.), will be
entertained within a period of three months from the date of the concerned
Convocation Ceremony. No complaints will be entertained after the specified
period.
4) Two identical passport size photographs (size 35 mm X 45 mm), of which
one duly attested by Dean/Principal of the concerned college should be
pasted on the form at the space provided for it and other photograph should
be enclosed in a small envelope and attached with the application. The name,
course and University PRN should be mentioned on the reverse side of photo.
No photograph, other than the stipulated size i.e. 35mm X 45mm (Visa type),
will be accepted.
5) Please check the details of Convocation Ceremony on the University web
site<www.muhs.ac.in>, which will be notified one month in advance from the
date of Convocation Ceremony.
6) Candidates are advised to collect his / her degree certificate within one
year from the date of convocation or else retention fee will be charged as
per University rules prescribed from time to time.
For Official Use only
The applicant’s name, academic and other details as stated in this
application have been checked with the office record and found to be
correct/incorrect.
Acknowledgement/Discrepancy letter no. . . . . . . . . . . . . . . issued.

I/c Faculty

NAME & POSTAL ADDRESS OF THE APPLICANT

(To be filled in by the Candidate)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .PIN Code . . . . . . . .

ACKNOWLEDGEMENT SLIP
(For Official Use only)
Convocation application in respect of . . . . . . . . . . . . . . . . . .
PRN. . . . . . . . . . . . has been duly received and found to be correct
in all respects. Degree/Diploma Certificate will be issued in person to
the applicant on production of this receipt and photo identity OR to the
blood relatives, i.e. Father/Mother/Brother/Sister, of the applicant on
production of their photo identity and an authority letter from the
applicant, on the day of the Convocation Ceremony or any working day,
after a month of the Convocation Ceremony.
I/c Faculty
 egkjk"V! vkjksX; foKku fo|kihB] ukf'Ad
MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK
fnaMksjh jksM] EgljQG] ukf'kd&422004] Dindori Road, Mhasrul, Nashik-422004
Email: coe@muhs.ac.in, examadmin@muhs.ac.in / Website: www.muhs.ac.in
Tel : PG Medical: 0253-2539252/258, PG Dental: 0253-2539259/254, PG Ayurved: 0253-25392255,
PG Homoeopathy: 0253-2539256, PG ALLIED: 0253-2539253/267

Application for PG Degree / PG Diploma Certificate. To be filled & submitted

by the successful candidate immediately after declaration of Final Year result.
(Before filling this form, please read the instructions given at the end. Fill up the Affix a photograph
of size 35mm
form in CAPTAL letters only) x45mm duly signed
across
To, & attested by
The Registrar, Dean/Principal of
Maharashtra University of Health Sciences, the Concerned
Nashik. college.

Mandatory Enclosures:-
(i) Attested photo copy of Passing Certificate (PG Degree / PG Diploma).
(ii) One additional photograph.
(iii) Attested photo copy of UG Degree Passing Certificate / UG Degree Marks Statement.

Sir,
I hereby apply for PG Degree / PG Diploma certificate of the University at the ensuing
convocation, to be held in the month of November / December / March /April, 20_______

PERSONAL DETAILS
1) Applicant’s Full Name in English (as per UG Degree Certificate) (one block Should be kept blank
between two words)

2) Name in Devnagri Script (Marathi):

3) Sex : (Male Female ) Phone No.: Mobile No :
4) Address for Correspondence: Email Id : __________________

Pin Code
5) Name of College / Institute: .………………………………………………………………………
6) College Code: …………………. Month & Year of Passing final year: ………………………….
7) University Permanent Registration No. ……………………..... Seat No.: ……………………….
8) Convocation Attendance Status ( P – In Person, A – In Absentia )

DECLARATION BY THE CANDIDATE

I have carefully read & noted the Instructions, before filling in this form. I declare that the information
given above is true and correct to the best of my knowledge and belief. I undertake that I shall be
responsible for any omission / errors and wrong / incomplete entries made by me in this form.

Place:
Date : Signature of Applicant
 INSTRUCTIONS TO THE APPLICANT

1) Incomplete forms and forms without attested photo copies of Final year passing Certificate, UG
Degree Passing certificate / UG Degree Marks Statement, will not be accepted.

2) The acknowledgement of this form should be preserved carefully and produced at the time of
collection of the PG Degree / PG Diploma Certificate on the day of the convocation, or as and
when the same is collected.

3) Any complaint, regarding non-receipt of PG Degree \ PG Diploma Certificate or correction in

Name, College, Class, Subject, Year of Passing, etc., will be entertained within a period of three
months from the date of the concerned convocation. No complaints will be entertained after the
Specified period.

4) Two identical visa type photograph (size 35mm X 45mm). Of which one duly attested by Dean
/ Principal of concerned college and should be pasted on the from at the space provided for it and
other photograph should be enclosed with application mentioning the course, name and
permanent registration Number on the reverse side. No photograph other than the stipulated size
i.e. 35mm X 45mm (Visa type) will be accepted.

5) Please check the details of convocation programme on University web site

<www.muhs.ac.in>, which will be notified one month in advance from the date of convocation
Ceremony.
6) Candidates are advised to collect his / her degree certificate within one year from the date of
convocation or else retention fee will be charged as per University rules prescribed from time to
time.

For Office use only

The applicant’s name, Academic and other details as stated in this application have been
checked with the office record and have been found correct/ incorrect. Acknowledgement/
observation letter issued vide letter No ----------------- dated ----------------------------------

In-charge Faculty

NAME & ADDRESS OF THE CANDIDATE

(to be filled in by the Candidate)
--------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------
---------------------- Tal.: ---------------- Dist.: -------------------------- Pin code.: ----------------------

ACKNOWLEDGEMENT SLIP
Convocation Application in respect of ------------------------------------------------------------------------
PRN----------------------------Course---------------------------has been duly received and found
correct in all respects. Degree will be issued in person to the student on production of this receipt
and photo identity, to the blood relatives (Father/Mother/Sister/Brother) of the student on
production of their photo identity and the authority letter issued by the concerned student on the
day of convocation or any working day after one month from the date of convocation.

In-charge Faculty