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Tannu Mishra's JEE Polytechnic 2018 Form

Tannu Mishra, a female student from Deoria, Uttar Pradesh, India, has applied for the Joint Entrance Examination (Polytechnic) UP 2018 to study in Group A. She is a general category candidate from a rural area with Domicile of Uttar Pradesh. She has submitted her application on January 22nd, 2018 after paying a fee of Rs. 300 through an online transaction with an ID of CPC5665113. If selected, her first choice for exam center is Deoria and second choice is Gorakhpur.

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Harsh Tiwari
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86 views1 page

Tannu Mishra's JEE Polytechnic 2018 Form

Tannu Mishra, a female student from Deoria, Uttar Pradesh, India, has applied for the Joint Entrance Examination (Polytechnic) UP 2018 to study in Group A. She is a general category candidate from a rural area with Domicile of Uttar Pradesh. She has submitted her application on January 22nd, 2018 after paying a fee of Rs. 300 through an online transaction with an ID of CPC5665113. If selected, her first choice for exam center is Deoria and second choice is Gorakhpur.

Uploaded by

Harsh Tiwari
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Joint Entrance Examination (Polytechnic) UP 2018

Uttar Pradesh
Confirmation Page

Application No. 5223805 -


DO NOT SEND THIS PAGE TO BOARD.
CANDIDATES ARE REQUESTED TO RETAIN THE PRINTOUT OF ACKNOWLEDGEMENT PAGE FOR FUTURE REFERENCE.

Personal Details :
Name : TANNU MISHRA Date of Birth : 16-08-2003
Mother's Name : SAVITA DEVI Category : General
Father's Name : SANJAY MISHRA SubCategory : Not Applicable
Gender : Female Have you applied for other No
Group in this exam? :
?
Nationality : Indian Place of Residence : Rural
Are you belong to Minority : No State of Eligibility : Domicile of U.P.

Apply For :
Apply For : GROUP A
First Exam City : DEORIA Second Exam City : GORAKHPUR

Educational Details :
Qualification Pass Course/Stream Name Board/University Name Year Of Marks (%) Roll No. Institute Name & Address Pin code of
Status Passing Place of
Institute
10th or equivalent Passed 10th U P BOARD OF HIGH 2017 70 2430032 SHRI GANDHI ADARSH 274001
SCHOOL AND INT COLL REOLI DEORIA
INTERMEDIATE
EDUCATION

Contact Details :
Address : LAR ROAD City/Town/Village : DEORIA
District : DEORIA State : UTTAR PRADESH
Pin Code : 274505 Email ID : vij***************@gmail.com
Mobile Number (+91) : 879****130 Land Line No. with --
(+91) STD Code :

Fee Payment Details


Payment Mode: Pay through SBI(MOPS) Transaction ID: CPC5665113
Exam Fee: 300 /- Date of Transaction: 22/01/2018
Fee Submitted On: 22/01/2018
Declaration
I hereby declare that all the particulars given by me in this application form are true to the best of my knowledge and belief and any mistake / misinformation detected at
the time of admission or at any stage in future will result in the cancellation of admission. I have read and understood the procedures of the Application Form. I shall
abide by terms and conditions thereon.

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Photograph : ,Left Thumb Impression : ,Signature :

Date of Printing : 22/01/2018 02:48:24 PM

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