West Bengal Joint Entrance Examinations Board

(JELET)-2019
Confirmation Page

Application No. 19090005264 -

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 SHYAMLAL KUMAR Date of Birth 07-03-2001
Mother's Name SHANTOMONI KUMAR Category OBC-B
Father's Name KANGSA KUMAR Gender Male
Person with Disability (PwD) No Nationality Indian
Home District PURULIA Religion Hindu
Domicile WEST BENGAL Blood Group B+

Apply For
Application Type JELET-2019 (All other Diploma holders in 1st Choice of Exam City Durgapur
engineering/technology.)
2nd Choice of Exam City Asansol

Academic Details
Qualifying Pass Course/Stream Name Board/Council/Universi Year of Result Marks Detail RollNo Institute Institute
Examination Status ty Name Passing/ap Mode Name & Pin
(Dip./B.Sc.) pearing Address code
Diploma/B.S.c Appeari Civil Engg. (CE) Any Other Recognised 2019 NA NA D19505 DR. 713206
ng Board/ University - 1005- B.C.ROY
WEBSCTE 03059 POLYTECH
NIC,Dr.
Meghnad
Saha
Sarani,Bidh
annagar,Du
rgapur,Dist-
Paschim
Bardhaman
,W.B.

Communication Details
Address BAMANIA Locality
Sub locality KOTSHILA District PURULIA
State WEST BENGAL Pin Code 723213
Email Id lal*********@gmail.com Mobile no 891****099
Land Line No. with --
STD code or any
other Contact No.

Fee Payment Details

Payment Mode: Online Payment Transaction ID: QUR27408985544
Exam Fee: 500 /- Date of Transaction: 06-04-2019 11:17:44
Fee Submitted On: 06/04/2019
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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Photograph,Signature

Date of Printing : 06/04/2019 11:17:18 AM