West Bengal Joint Entrance Examinations Board

(PUBDET)-2019
Confirmation Page

Application No. 19020002299 -

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

Personal Details
Candidate's Name SHRUTI BHATTACHARYA Date of Birth 05-05-2001
Mother's Name MAHUYA BHATTACHARYA Category General
Father's Name SOMNATH BHATTACHARYA Gender Female
Person with Disability (PwD) No Nationality Indian
Home District COOCHBIHAR Religion Hindu
Domicile WEST BENGAL Blood Group A+

Apply For
Courses applied for Presidency University Bachelor Degree Entrance 1st Choice of Paper Life Science
Test
2nd Choice of Paper Chemistry 1st Choice of Exam City Coochbihar
2nd Choice of Exam City Siliguri

Academic Details
Qualification Pass Course/Stream Name Board/Council/Universi Year of Result Marks Detail RollNo/ Institute Institute
Status ty Name Passing Mode Enroll Name & Pincode
No. Address. .
12th or Appeari Science WEST BENGAL 2019 NA NA NA MAHARANI 736101
equivalent ng COUNCIL OF HIGHER INDIRA
SECONDARY DEVI
EDUCATION BALIKA
VIDYALAY
A, KESHAB
ROAD,
COOCHBE
HAR

Communication Details
Address TEMPLE STREET BYE LANE Locality WARD NO 18
Sub Locality PATAKURA District COOCHBIHAR
State WEST BENGAL Pin Code 736101
Email Id som*****@yahoo.com Mobile no. 861****479
Land Line No. with --
STD code or any
other Contact No.

Fee Payment Details

Payment Mode: Online Payment Transaction ID: PSBI7213729812
Exam Fee: 500 /- Date of Transaction: 13-02-2019 21:43:37
Fee Submitted On: 13/02/2019
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 : 13/02/2019 09:42:00 PM