JOINT CSIR - UGC NET DECEMBER 2019

Confirmation Page

Application No. 1916 2021 3862 -

DO NOT SEND THIS PAGE TO NATIONAL TESTING AGENCY (NTA).
CANDIDATE IS REQUESTED TO RETAIN THE PRINTOUT OF CONFIRMATION PAGE FOR FUTURE REFERENCE.

Personal Details
Candidate's Name KAJAL BHATI Date of Birth 30-04-1999
Mother's Name BABITA Category OBC- NCL (Central List)
Father's Name RAVINDRA KUMAR BHATI Gender Female
Are you Single Girl Child in your family NO If you are a PwD Candidate, No
without brother or sister? do you have benchmark
disability (40% or more /
“Severe” where percentage is
not defined) ?
Nationality Indian Do you belong to Minority No
Community ?
Name of Minority Community Are You Diabetic? NO

Apply For
Apply For Applied for Lectureship/Assistant Professor Subject Opted for NET Mathematical Sciences
Specialization Applied Mathematics Medium of Question paper English
1st Choice for Exam City UTTAR PRADESH - GHAZIABAD 2nd Choice for Exam City DELHI (NCT) - DELHI/NEW DELHI
3rd Choice for Exam City HARYANA - SONIPAT 4th Choice for Exam City UTTAR PRADESH - ALIGARH

Specialization Detail
Specialization, if Any

Contact Details
Address PUKTA BAZAR SARDAR GANJ JAHANGIRABAD Locality SARDAR GANJ JAHANGIRABAD BULANDSHAHAR
BULANDSHAHAR
City/Town/Village JAHANGIRABAD District BULANDSHAHR
State /UT UTTAR PRADESH Pin Code 202394
Email Address bha***********@gmail.com Mobile Number (+91) 863****822
Land Line No. with --
STD code or any
other Contact No.

Fee Payment Details

Payment Mode: Pay through SBI(MOPS) Transaction ID: CPV3576953
Exam Fee: 500 /- Date of Transaction: 09/10/2019 20:47:07
Fee Submitted On: 09/10/2019
DECLARATION
I hereby declare that all the particulars given by me in this form are true to the best of my knowledge and belief and any mistake / misinformation, detected at the time
of admission or at any stage in future, will result in the cancellation of admission/candidature. I have read the information bulletin and understood all the procedures. In
case I furnish any false information, my result will not be declared/ my candidature will automatically stand cancelled. I shall abide by terms and conditions therein.

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Photograph Signature

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