12/9/2018 Student Registration

Thanks for submitting your Application

Form181D0060165which can be used for all
future correspondence
Amount: 4000
Payment Transaction No: PUR26980355395

Student Registration Form Helpdesk

Student Profile Details

Application Sequence Number: 181D0060165

Session: 2018-2019

Student Name: MASUD RANA

Degree: UG

Course of Study: Bachelor of Medicine and Bachelor of Surgery

Subject: MBBS

College Id: 1D006

College Name: JAGANNATH GUPTA INSTITUTE OF MEDICAL SCIENCES & HOSPITAL

Whether employed to any organization or not?: No

Date Of Birth: 07/Nov/1998

Gender: Male

Marital Status: Single

Is Differently Abled?: No

Religion: Muslim

Caste Category: OBC-A

Mother's Name: HASINA BIBI

Father's Name: SAHA ALOM MIAH

Aadhar Number: 355704348398

Caste Certificate

To view Caste Certificate.here.

Age Proof Certificate

To view Age Proof Certificate.here.

Higher Secondary Marks Details

Subjects Total Marks Obtained Marks Marks%

Physics 100 90 90.00

Chemistry 100 93 93.00

Biology 100 94 94.00

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12/9/2018 Student Registration

Total Aggregate Percentage

Total PCB Percentage: 92.33

Permanent Address Details

Address Line 1: DINHATA, BABUPARA, WARD NO.02

City/Locality/Village: DINHATA

Adress Line 2: PO.DINHATA, PS.DINHATA

District: Cooch Behar

State: West Bengal

Country: India

Pincode: 736135

Present Address Details

Address Line 1: K.P.MONDAL ROAD, BUITA, BUDGE BUDGE

City/Locality/Village: BUDGE BUDGE

Adress Line 2: NEAR CHARIAL MORE

District: Kolkata

State: West Bengal

Country: India

Pincode: 700137

Contact Details

Email ID: masudranabsf012@gmail.com

Mobile Number: 9679754507

Previous Academic Qualification(s)

Sr Year of Roll Total Marks Marks

Name Of Examination Board/University Marksheets
no. Passing No. Marks Obtained %

ALL INDIA SENIOR SCHOOL CENTRAL BOARD OF To view Marksheets and

1. 2016 6623388 500 444 88.80
CERTIFICATE EXAMINATION SECONDARY EDUCATION Certificates click here.

ALL INDIA SECONDARY SCHOOL CENTRAL BOARD OF To view Marksheets and

2. 2014 6124286 500 466 93.20
EXAMINATION SECONDARY EDUCATION Certificates click here.

Break In studies

Whether you have any Break in studies: Y

To view Principal attested candidate declaration

here.

Previously Registered to any other University

Whether you have previously registered to any other

N
University?:

Presently Registered to West Bengal University of Health Science

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12/9/2018 Student Registration

Whether presently registered in West Bengal University

N
of Health Science?:

Payment Details

Amount: 4000

Payment Transaction No.: PUR26980355395

Payment Order Id: 181D006016520181209182911646

Declaration

"I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. If any of these
   
information provided is found false/incorrect. I shall abide by the actions/decisions taken by the University."

Signature      

Version 13.05.01

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