Patliputra University UG Admission Application - 2024 PDF

Patliputra University, Patna Under-Graduate Self-Finance (UG-V) Admission Application Form SESSION 2024 UAN # 24U0174919 Appl. Date...

Patliputra University, Patna Under-Graduate Self-Finance (UG-V) Admission Application Form SESSION 2024 UAN # 24U0174919 Appl. Date : 9 August, 2024 02:13 PM 1. Candidate Name : SAURABH KUMAR 2. Father's Name : SHAILENDRA SINGH 3. Mother's Name : SWETA DEVI 4. Date of Birth : 01-Aug-2006 5. Gender : MALE 6. Category : General 7. Sub Category : Not Applicable 8. Other Category : Not Applicable 9. AADHAAR : 24*******980 10. Domicile : Bihar 11. Dom. Cert. : BRCCO/2024/5281246 12. Religion : Hindu 13. Minority : NO 14. Nationality : INDIAN 15. EWS Status: I have EWS certificate 16. Address for Correspondance : 17. Permanent Address : VILLAGE : GORTARA , POST : BHAROOB , POLICE VILLAGE : GORTARA , POST : BHAROOB , POLICE STATION : OBRA STATION : OBRA Aurangabad Aurangabad Bihar Bihar PIN Code : 824124 PIN Code : 824124 18. Mobile : 8603061361 19. Email : [email protected] 20. Payment Details: Paid Rs.1100.00 on 9/8/2024 Ref# 4043082126845 Bank Ref: UPI - 422252337069 21. Qualifications Examination Board/University Year Roll No. Max. Mrk. Obt. Mrk. 83083210019 Highschool Bihar School Exam. Board, Sinha Library Road, Patna 2021 500 355 7 24021230103 Intermediate Bihar School Exam. Board, Sinha Library Road, Patna 2023 500 346 35 Subjects/Stream : Science Subject Obtained Marks Max Marks Percentage % Physics 69 100 69.00 Chemistry 66 100 66.00 Mathematics 67 100 67.00 English 65 100 65.00 Hindi 79 100 79.00 Other Qualifications 22. Quota Selection 23. College/Course Chosen (in order of preference) Pref# College Degree Subject 1 College of Commerce, Arts and Science, Patna B.C.A. Computer Application 2 Ram Krishna Dwarika College, Patna B.C.A. Computer Application Declaration Printed: Monday, September 30, 2024 10:04 AM Page: 1/2  Patliputra University, Patna Under-Graduate Self-Finance (UG-V) Admission Application Form SESSION 2024 UAN # 24U0174919 Appl. Date : 9 August, 2024 02:13 PM 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. I will follow the regulations on curbing the menace of ragging in higher educational institutions, 2009. 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: Monday, September 30, 2024 10:04 AM Page: 2/2