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STUDENT GRIEVANCE REDRESSAL FORM
Shri Kalidas Ayurvedic Medical College And Hospital, Badami.
Note:
All grievances will be handled with
strict confidentiality
and adddressed within the stipulated time as per
NCISM norms
* Indicates required question
Email
*
Record my email address with my response
FULL NAME OF THE STUDENT
*
Your answer
UNIVERSITY REGISTRATION NUMBER
*
Your answer
COURSE & YEAR
*
BAMS- 1ST PHASE
BAMS-2ND PHASE
BAMS -3RD PHASE
INTERN
CONTACT NUMBER
*
Your answer
EMAIL ID
*
Your answer
NATURE OF GRIEVANCE
*
ACADEMIC ISSUE
TEACHING-LEARNING PROCESS
EXAMINATION/EVALUVATION
ATTENDANCE RELATED
CLINICAL/HOSPITAL TRAINING
INFRASTRUCTURE/FACILITIES
RAGGING/HARASSMENT
DISCRIMINATION/BIAS
PERSONAL
DETAILED DESCRIPTION OF THE GRIEVANCE
*
Your answer
HAVE YOU REPORTED THIS GRIEVANCE EARLIER
*
Yes
No
IF YES TO WHOM WAS IT REPORTED
*
Your answer
ACTION TAKEN EARLIER(IF ANY)
*
Your answer
DO YOU WISH TO KEEP YOUR IDENTITY CONFIDENTIL FROM THE CONCERNED PARTY
*
Yes
No
DECLARATION (MANDATORY)
I HEREBY DECLARE THAT THE INFORMATION FURNISHED
ABOVE IS TRUE AND CORRECT TO THE MY KNOWLEDGE.I UNDERSTAND THAT MY GRIEVANCE WILL BE EXAMINED AND RESOLVE AS PER
NCISM REGULATIONS
AND
THE INSTITUTIONAL POLICES Of SHRI KALIDAS AYURVEDIC MEDICAL COLLEGE AND HOSPITAL BADAMI.
*
I Agree
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