Personal Details

User ID 8112824
BHAVNA PATNAIK
Candidate's Name

Date of Birth 05/Mar/1997

Country India

Email ID bhavnapatnaik5397@gmail.com

Mobile Number 8018818666

Other Personal Details

Father's/Husband's/Guardian's JATINDRA KUMAR PATNAIK
Name
GITANJALI PATNAIK
Mother Name

Category: General State/Union Territory of Caste/Tribe:

Serial/Entry Number of Caste/Tribe: Gender: Female

Nationality: Indian Other Nationality:

Caste/Tribe Name: Aadhaar Card Number: 933778170253

Do you belong to Persons with Disabilities (PwD) category as per RPwD Act 2016: No

PwD Category:

Do you require wheelchair support at the test centre?: Would you be using a scribe for the Test?:

Communication Address
plot no - 4590 , gadhkan main road near Subhashree Villa
Address Line1

Address Line2 Mancheswar , Bhubaneswar

Address Line3

Country: India Other Country:

State: Odisha Other State:

District: Khordha Other District:

Town/City: Bhubaneswar Pincode: 751017

Alternate Email Address : abinash025@gmail.com

Emergency Contact Details

Emergency Mobile Number: 7735554191 Relationship with Candidate: Mother

SSC/10th/Equivalent Details

SSC/10th/Equivalent Board Central Board of Secondary Education

Name

Other Board Name

Month/Year of Completion: March 2013 Maximum Marks (Inclusive of all subjects): 500

Total Marks Obtained (Inclusive of all subjects): 380 Aggregate Percentage (%) :76

HSC/12th/Equivalent/Diploma Course Details

Course Type HSC

University/Board/Other

Authority Name

Orissa Council of Higher Secondary Education

HSC Board Name

HSC Other Board Name

Duration of Diploma Course (In Year): HSC Discipline: Science

HSC Other Discipline

Month/Year of Course Commencement: Month/Year of Completion: March 2016

Maximum Marks (Inclusive of all subjects): 600

Total Marks Obtained (Inclusive of all subjects): 320
Aggregate Percentage (%): 53.33

Bachelor's Degree Details

Are you in the final year of Bachelor's Degree?: Yes

Have you completed Bachelor's Degree?: Total Duration of Degree: 3 Year

Current Semester: Semester-5 Aggregate Marks (%): 62.32

Private University
Type of University/Institution

Other Type of

University/Institution

Odisha
State/Union Territory of

University
 Others
University/Institute Name

ASBM Institute of Professional Studies

Other University/Institute Name

ASBM Institute of Professional Studies

Name of College/Institution

BBA
Degree Name

Other Degree Name

Management (Business Administration/Business Management/Business Studies/Management

Discipline Studies)

Does the 'Other Discipline' closely relate to 'Engineering/Technology'?:

Other Discipline:

Month/Year of Course Commencement : August 2016

Probable Month/Year OR Month/Year of Completion: April 2019

Second Bachelor's Degree Details

Are you in the final year of Bachelor's Degree?:

Have you completed Bachelor's Degree?: Total Duration of Degree:

Current Semester: Aggregate Marks (%):

Type of University/Institution

Other Type of

University/Institution

State/Union Territory of

University

University/Institute Name

Other University/Institute Name

Name of College/Institution

Degree Name

Other Degree Name

Discipline

Does the 'Other Discipline' closely relate to 'Engineering/Technology'?:

Other Discipline:

Month/Year of Course Commencement:

Probable Month/Year OR Month/Year of Completion:

Master's Degree Details

Do you want to enter Master's Degree details? No

Master's Degree Completion Status: Total Duration of Degree:

Current Semester: Aggregate Marks (%):

Type of University/Institution

Other Type of

University/Institution

State/Union Territory of

University

University/Institute Name

Other University/Institute Name

Name of College/Institution

Degree Name

Other Degree Name

Discipline

Does the 'Other Discipline' closely relate to 'Engineering/Technology'?:

Other Discipline:

Month/Year of Course Commencement:

Probable Month/Year OR Month/Year of Completion

Other Professional Degree Details

Have you completed any professional degree such as CA/CS/ICWA?: No

Degree CA ICWA CS

Degree Completion Status

Name Of Professional Degree

Professional Inter Marks (%): Professional Final Marks (%):

Month/Year of Course Commencement: Month/Year of Completion:

Work Experience
Industry Type Work Experience Industry Type Work Experience

Automobiles/Auto-ancillaries Banking/Financial Services

Durables Engineering/Industrial
Fast Moving Consumer Information Technology
Goods (FMCG)
Pharmaceuticals/Healthcare Retail

Others Telecommunications

Total Work Experience (In months as on July 31 2018):

Programmes

Programme Names Interview City Selected/Not

IIM Ahmedabad PGP Not Selected

IIM Ahmedabad PGP Not Selected

IIM Ahmedabad PGP-FABM Not Selected

IIM Ahmedabad ePGP Not Selected

IIM Ahmedabad ePGP Not Selected

IIM Ahmedabad FPM Not Selected

IIM Amritsar PGP Not Selected

IIM Bangalore PGP Not Selected

IIM Bangalore PGPEM Not Selected

IIM Bangalore PGPPM Not Selected

IIM Bangalore FPM Not Selected

IIM Bodh Gaya PGP Not Selected

IIM Calcutta PGP Not Selected

IIM Calcutta FPM Not Selected

IIM Indore PGP Not Selected

IIM Indore PGP-HRM Not Selected

IIM Indore FPM Not Selected

IIM Jammu PGP Not Selected

IIM Kashipur PGP Not Selected

IIM Kashipur EPGP Not Selected

IIM Kashipur FPM Not Selected

IIM Kashipur EFPM Not Selected

IIM Kozhikode PGP Not Selected

IIM Kozhikode EPGP IIMK Not Selected

IIM Kozhikode EPGP IIMK

Not Selected
Kochi Campus

IIM Kozhikode FPM Not Selected

IIM Lucknow PGP Not Selected

IIM Lucknow PGP-ABM Not Selected

IIM Lucknow PGP-SM Not Selected

IIM Lucknow FPM Not Selected

IIM Nagpur PGP Not Selected

IIM Raipur PGP Not Selected

IIM Raipur FPM Not Selected

IIM Raipur EFPM Not Selected

IIM Ranchi PGP Not Selected

IIM Ranchi PGP-HRM Not Selected

IIM Ranchi PhD Not Selected

IIM Ranchi EPhD Not Selected

IIM Rohtak PGP Not Selected

IIM Rohtak EPGPX Not Selected

IIM Rohtak FPM Not Selected

IIM Rohtak EFPM Not Selected

IIM Sambalpur PGP Hyderabad Selected

RGIIM Shillong PGP Not Selected

RGIIM Shillong PGPEX Not Selected

RGIIM Shillong FPM Not Selected

IIM Sirmaur PGP Not Selected

IIM Tiruchirappalli PGP Not Selected

IIM Tiruchirappalli PGPBM Not Selected

IIM Tiruchirappalli FPM Not Selected

IIM Udaipur PGP Not Selected

IIM Udaipur FPM Not Selected

IIM Visakhapatnam PGP Not Selected

IIM Visakhapatnam FPM Not Selected

Test City Preferences

Preferred Test City 1: Bhubaneswar Preferred Test City 2: Berhampur

Preferred Test City 3: Cuttack Preferred Test City 4: Sambalpur

Payment Details

Payment Mode: online Amount: 1900

Payment Status: S Payment Transaction Number: NHMP6644296750

Order ID: 811282420180904094818272

Declaration

I hereby certify that the information given by me in this Application Form is true to the best my knowledge. I certify that I fulfill the CAT
2018 eligibility criteria and undertake to produce original documents whenever necessary and I will not demand any reschedule of
exam. I agree to abide by the declaration of the authorities regarding the eligibility of my application and understand that any
misrepresentation or omission of facts in my application may justify cancellation of my CAT 2018 application and scores. I understand
that all disputes will be subject to the territorial jurisdiction of city of Kolkata only.