Application ID

JHUUGC658701B

Nationality

Indian

Payment mode

Net Banking

Program name

MBBS & UG (Biological

Sciences)

Submitted Date &

Time

19 April. 2015, 09:47 PM

Application status

Payment Received

Admission Session

2015-16

Billed Amount

1863

Reference Number

CCACD1AED221

1-101 - MBBS - General Category

Course Selected:
2-109 - BSc (Hons.) Nursing

Applicant Name

RAJAT KUMAR SABHARWAL

Father's Name

OM PRAKASH SABHARRWAL

Social Category

General

Mother's Name

VANDANA SABHARWAL

Physically Challenged

NO

Parent Annual Income

Below Rs. 1,00,000

Religion

HINDUISM

Date of Birth (DD-MM-YY) 14-4-1998

Mobile Number

9467899968

Other Mobile Number (If

Any)

7027322623

Email ID

YEATESH21@gmail.com

Other E-Mail Address(If

Any)

YTSH@INDIA.COM

Gender

MALE

JH-Employee's Ward

NO

State of Domicile

HIMACHAL PRADESH

Sports Person

NO

Qualifying Exam

10+2

Internal Candidate Info

NONE OF THE ABOVE

Locomotor disability

NO

Marital Status

UNMARRIED

Do you want to enroll

under Self Financing
Scheme (SFS) also ?*

Yes

Correspondence address

H.NO 166 WARD 17, PARADE MOHALLA ,KALKA

,HARYANA-KALKA-133302

Permanent address

H.NO 166 WARD 17, PARADE MOHALLA ,KALKA

,HARYANA-KALKA-133302

Qualifying Exam Status

RESULT AWAITED

Qualifying Exam

10+2

Qualifying University

CENTRAL BOARD OF
SECONDARY EDUCATION

Qualifying Year

2015

Is Enrolled in Jamia Hamdard ?

Are you applying for MBBS ?

NO

Enrollment number

NA

Name of the Exam

Enrollment Year*

Enter AIPMT Reg No.

6454086

Enter AIPMT Roll .No

50510898

Declaration: I Declare that all the statement given in this application form are true to the best of my knowledge. I understand that if any of the statements is found wrong my admission will stand
cancelled. If admitted, I will abide by the rule & regulations in force in Jamia Hamdard and as amended from time to time and pay the prescribed fee regularly.
.

Mother's
Signature

Father's
Signature