Graduate Pharmacy Aptitude Test

(GPAT)-2019
Confirmation Page

Application No. 190210011738 -

DO NOT SEND THIS PAGE TO BOARD.
CANDIDATE IS REQUESTED TO RETAIN THE PRINTOUT OF CONFIRMATION PAGE FOR FUTURE REFERENCE.

Personal Details
Candidate's Name SURESH KUMAR Date of Birth 08-06-1996
Mother's Name KRISHNA Category OBC-NCL
Father's Name BIJENDER SINGH Gender Male
Person with Disability (PwD) with more No Nationality Indian
than 40% disability
State of Residence HARYANA Are You Diabetic? NO

Apply For
Apply For GPAT 2019 1st Choice for Exam City GURUGRAM
2nd Choice for Exam City DELHI/NEW DELHI 3rd Choice for Exam City HISAR
4th Choice for Exam City FARIDABAD

Details of Academic Qualification

Qualification Pass Status Name of Examination Name of University Year of
Passing/Appearing
Graduate Appearing Bachelor of Pharmacy Baba Mast Nath University, 2019
or Equivalent Rohtak, Haryana. (Private
University)

Contact Details
Address V.P.O AMARHERI Locality
City/Town/Village JIND District JIND
State HARYANA Pin Code 126102
Email Address SKj*****@gmail.com Mobile Number (+91) 868****043
STD code with --
Telephone No

Fee Payment Details

Payment Mode: Pay through SBI(MOPS) Transaction ID: CPL0305126
Exam Fee: 1400 /- Date of Transaction: 20/11/2018 18:28:01
Fee Submitted On: 20/11/2018
DECLARATION
I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. I have read and understood the Board
procedures. I shall abide by the terms and conditions thereon.

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Date of Printing : 26/11/2018 08:39:48 AM