Sarat Chandra Chattopadhyay Government Medical College & Hospital, Uluberia

Proforma for Execution of Bond by the candidate for availing of MBBS seat in government medical college in West Bengal (to be executed on Non-judicial Stamp Paper of denomination Rs. 100/- or above and notarized) I, Mr. / Ms. / Mrs. ........................................................................................ , son of / daughter of / wife of Mr. / Ms. / Mrs. .................................................................................. residing at...................... ………………………………………………..…………………………………………………………………………………………… ……..……… Dist. ................................... Pin .......................... having been selected for undergraduate medical degree (MBBS) course at ………………..………………………………………………………………………… do hereby affirm and solemnly declare that I shall deposit a sum of Rs. 1,00,000/- (Rupees One Lakh) only as prescribed by the Government of West Bengal in pursuance of G.O. No. HF/O/MERT/1542/Admn/ME/STM-28-10/2(10) dated 25.10.2010, if I resign/discontinue the course before completion of tenure of the course. Moreover, it shall be obligatory on my part to observe or perform all terms and condition prescribed by the Government for the aforesaid purpose. The original documents which are in the custody of the admitting institute, namely …………………………………………………………………………………………………………………………………………….. will not be returned to me unless and until I pay the penalty of Rs.1,00,000/- (Rupees One Lakh) only to the authority of ………………………………………………………………………………….. . This bond is imposed as there will be no further provision on behalf of the W.B.M.C.C. (West Bengal Medical counseling Committee), Department of Health & Family Welfare, Government of West Bengal, to allot another candidate to the same seat on completion of the admission process. Signature of the candidate: ............................................................................................ Name of the candidate: .....................................................................................