Burdwan Medical College, Burdwan

Execr-ition of bond oi the canrJiclaie 1'or Under Graduate [/edical/ Dental Degi'ee seat at BL,,rciwan iVledical Cc{lo,Je, Burcivvarr SrilSmt sio, Dio, \^ilo Residing at. .... Dist.. ... ..pirr ha'ring been selected fcr tncler gr;:dLl;:te m-oclicai degree course at Burclwan Medical College, Burdwan dc hereby afi;r-rn and solerrniy declarc tlrat I shalldeposit a sum of Rs. 1, 00,000/_ (Rupees one lal<lr ) as prescribeci Iiy Lhe Go,,,errrrncnt in prursuance of G.O. Nlo, HFiOiMERTllS42lt\drnnl I\4EiS'l-,tir-28-1AE(it)) clated 25.10.2010, if I resign/discontinue flre CoUrse before Compir-.lir.n oi tenui'e oI tire cou1-s-o. Moreovei' it shall be obligalory on rny part to observe or perfornr all terms arrd conditions prescribed by llre Governiner-rt for"ilte aforesaicl purpose. -l-he original documeritr; which ate in the custodrr of the .;.. ,... ........trui\\ not be returned to me unless and until l pay the peneity of Rs. 1, 00,000i- (Rlrpees one lakh )only to the authority of This bond is imposer.l as there r,vill be no fufther provision on behalf of ihe W.B.ffl.C..C. (West Bengal Medical Couirseling Coinmitlee), Department of l-lealth and Family Welfare Govt. of West Bengal to ailot another candiclale lor the sarne seat in the next round/s of counseling. Signalure of the (lancrcjate. Nanre of tlre Candidate . Date Dlcna r rsvv , I Signature of the Witrress .... . Name of the Witness