24G0040008.pdf

Patliputra University, Patna Under-Graduate (UG) Admission Application Form SESSION 2024 UAN # 24G0040008...

Patliputra University, Patna Under-Graduate (UG) Admission Application Form SESSION 2024 UAN # 24G0040008 Appl. Date : 8 May, 2024 02:17 PM 1. Candidate Name : SHAKTI DEV 2. Father's Name : KAMLESHWARI SINGH 3. Mother's Name : MANJU DEVI 4. Date of Birth : 30-Jul-2005 5. Gender : MALE 6. Category : BC-II 7. Sub Category : Not Applicable 8. Other Category : Not Applicable 9. AADHAAR : 66*******969 10. Domicile : Bihar 11. Dom. Cert. : 12. Religion : Hindu 13. Minority : NO 14. Nationality : INDIAN 15. EWS Status: Not Applicable/No EWS 16. Address for Correspondance : 17. Permanent Address : VILL-LEMUABAD PO-LEMUABAD PS-PANDARAK VILL-LEMUABAD PO-LEMUABAD PS-PANDARAK Patna Patna Bihar Bihar PIN Code : 803221 PIN Code : 803221 18. Mobile : 7759877157 19. Email : [email protected] 20. Payment Details: Paid Rs.600.00 on 12/5/2024 Ref# 9162808249233 Bank Ref: UPI - 413328452647 21. Qualifications Examination Board/University Year Roll No. Max. Mrk. Obt. Mrk. Highschool C.B.S.E. (Central Board of Secondary Edu. 2, Commu... 2021 12193643 500 391 17006230106 Intermediate Bihar School Exam. Board, Sinha Library Road, Patna 2023 500 397 53 Subjects/Stream : Science Subject Obtained Marks Max Marks Percentage % English 77 100 77.00 Hindi 83 100 83.00 Physics 84 100 84.00 Chemistry 77 100 77.00 Biology 76 100 76.00 Other Qualifications 22. Quota Selection 23. College/Course Chosen (in order of preference) Pref# College Degree Subject 1 A.N.S. College, Barh B.Sc. Zoology (Major) Zoology 2 Ram Ratan Singh College, Mokama, Patna B.Sc. Zoology (Major) Zoology 3 R.L.S.Y. College, Bakhtiarpur B.Sc. Zoology (Major) Zoology 4 Sri Bhuwaneshwari Raja Mahavidyalaya, Barh B.Sc. Zoology (Major) Zoology 5 Shri Ram Narayan College,Parsawan,Barh,Patna B.Sc. Zoology (Major) Zoology Printed: Thursday, June 6, 2024 07:19 AM Page: 1/2  Patliputra University, Patna Under-Graduate (UG) Admission Application Form SESSION 2024 UAN # 24G0040008 Appl. Date : 8 May, 2024 02:17 PM Pref# College Degree Subject 6 S.K.M.V. College, Fatuha B.Sc. Zoology (Major) Zoology 7 Nunuwati Jagdeo Singh Mahavidyalaya,Bakhtiya... B.Sc. Zoology (Major) Zoology 8 Kisan College, Nalanda B.Sc. Zoology (Major) Zoology 9 Nalanda College, Biharsharif B.Sc. Zoology (Major) Zoology 10 S.P.M College, Nalanda B.Sc. Zoology (Major) Zoology 11 R.P.S. College, Harnaut B.Sc. Zoology (Major) Zoology 12 College of Commerce, Arts and Science, Patna B.Sc. Zoology (Major) Zoology 13 A.N. College, Patna B.Sc. Zoology (Major) Zoology 14 B.D. College, Patna B.Sc. Zoology (Major) Zoology 15 A.N.S. College, Barh B.Sc. Botany (Major) Botany 16 Ram Ratan Singh College, Mokama, Patna B.Sc. Botany (Major) Botany 17 R.L.S.Y. College, Bakhtiarpur B.Sc. Botany (Major) Botany 18 Shri Ram Narayan College,Parsawan,Barh,Patna B.Sc. Botany (Major) Botany 19 Kisan College, Nalanda B.Sc. Botany (Major) Botany 20 Nalanda College, Biharsharif B.Sc. Botany (Major) Botany Declaration I declare that I have never been convicted for any criminal act and that there is no case pending against me in the court of law. I also declare that I have never been caught using Unfair Means or any Disciplinary action has been taken against me. If I was charged for using Unfair Means, the punitive duration is over and charges have been cleared. I have read carefully and have understood all rules as mentioned in the University Rules and Admission Brochure. Furthermore I also declare that if my application is found to contain incorrect/false information regarding my Name, Birth Date, Gender, Religion, Domicile, Weightage, Caste, Horizontal Reservation, Marks obtained or any other field, my application is liable to get cancelled, and I will have no objection in getting disqualified for admission to the concerned course/college. Signature of Parent/Guardian Signature of Candidate Date: Date: Document Checklist NOTE: Mark the number of documents ( Photocopy/Xerox) attached by the Candidate during form submission to the college Xth Marksheet Xth Certificate XIIth Marksheet Last Exam Passed Marksheet Recent Passport Sized Photograph Scanned Signature Domicile (for other state) Certificate for Kashmiri Resident Certificate for Category Certificate for Sub-Category Documents for Claiming Weightage Other Certificate/Document Printed: Thursday, June 6, 2024 07:19 AM Page: 2/2