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Personal Details
APPLICATION SEQUENCE COM072511
NUMBER:
Applying For:
APPLYING FOR: PCM-COMEDK UGET ONLY

Personal Information
FULL NAME OF THE ANKIT SHRIVASTAVA
APPLICANT :
MOBILE NUMBER : 9130840062
EMAIL ID : ANKITX.SRI@GMAIL.COM

FATHER'S/GUARDIAN'S FULL VIRENDRA KUMAR SHRIVASTAVA


NAME :
MOTHER'S FULL NAME : MINU SHRIVASTAVA

Other Personal Information


DATE OF BIRTH : 2001-03-17
UNIQUE ID PROOF OF AADHAR CARD
APPLICANT :
UNIQUE ID PROOF NUMBER 443116123279
OF APPLICANT :
GENDER : MALE
PERSON WITH
NO
DISABILITY(PWD) :
WHETHER YOU NEED SCRIBE? NA
PARENT'S/GUARDIAN'S
LESS THAN RS 6.5 LACS P.A
ANNUAL INCOME:
NATIONALITY: INDIAN NATIONAL
PARENTS/GUARDIAN'S
9764902502
MOBILE NUMBER:
PARENT'S/GUARDIAN'S VOTER ID
UNIQUE ID PROOF:
PARENT'S/GUARDIAN'S:
IUA1854751
UNIQUE ID PROOF NUMBER:
Correspondence Address for communication purpose
PRESENT ADDRESS H.NO.371/A, NEAR JAISWAL SCHOOL
LINE 1:

PRESENT ADDRESS VIKAS NAGAR


LINE 2:

PRESENT ADDRESS
LINE 3 :

PRESENT ADDRESS STATE: UTTAR PRADESH

PRESENT ADDRESS DISTRICT: CHANDAULI

PRESENT ADDRESS NA
OTHER DISTRICT:
PRESENT ADDRESS CITY: MUGHALSARAI

PRESENT ADDRESS PIN CODE: 232101

Permanent Address
PERMANENT ADDRESS LINE 1: H.NO.371/A, NEAR JAISWAL SCHOOL

PERMANENT ADDRESS LINE 2: VIKAS NAGAR

PERMANENT ADDRESS LINE 3:

PERMANENT ADDRESS STATE: UTTAR PRADESH


PERMANENT ADDRESS CHANDAULI
DISTRICT :
PERMANENT ADDRESS NA
OTHER DISTRICT:
PERMANENT ADDRESS CITY: MUGHALSARAI
PERMANENT ADDRESS PIN
232101
CODE:
Category Details:
BELONGS TO : NON KARNATAKA
BIRTH/DOMICILE: NA

LINGUISTIC MINORITY: NA
RELIGIOUS MINORITY: Not Applicable
DO YOU BELONG TO
NA
HYDERABAD KARNATAKA
REGION?
CATEGORY : GENERAL MERIT (GM)

SUB CATEGORY: NA

Academic Details:
QUALIFYING EXAM:
12th STD

OTHER QUALIFYING EXAM:


NA

QUALIFYING EXAM PURSUING


COMPLETED/NOT:
MONTH AND YEAR OF NA NA
PASSING QUALIFYING EXAM:
BOARD OF QUALIFYING
CBSE
EXAM:

OTHER BOARD OF
NA
QUALIFYING EXAM:

NAME OF INSTITUTION LAST ROYAL GONDWANA PUBLIC SCHOOL


STUDIED:

PLACE OF INSTITUTION LAST NAGPUR


STUDIED:

ROLL/REG/INDEX NO OF 10TH 5035367


STANDARD MARKS CARD:
ROLL/REG/INDEX NO. OF 12TH NA
STD/2ND PUC MARKS CARD
OTHER ENTRANCE EXAMS JEE
BEING PURSUED
Exam City Preferences
EXAM CITY PREFERENCE 1 MAHARASHTRA-NAGPUR

EXAM CITY PREFERENCE 2 MAHARASHTRA-AMRAVATI


EXAM CITY PREFERENCE 3 MADHYA PRADESH-BHOPAL
Payment Details
PAYMENT STATUS: PAYMENT SUCCESS

PAYMENT AMOUNT: 1534

PAYMENT TRANSACTION 201810647900107


NO.
Additional Payment Details
PAYMENT STATUS:
PAYMENT AMOUNT:
PAYMENT TRANSACTION
NO.
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