Telangana Residential Educational Institutions Society (Regd.

), Hyderabad
Application for TSRJC Common Entrance Test-2019 for admission into Intermediate FIRST Year in
TSR Junior Colleges

Personal Details
1 Reference Id : 1340059546
2 Surname : KAMBALA
3 Candidate Name : KAMBALA PRANEETH
4 Father Name : KAMBALA NARAYANA
5 Mother Name : KAMBALA TARA
6 Date of birth : 16/1/2004
7 Gender : Male
8 Address : HNO 1-112 PENCHIKALPET

Mandal : PENCHIKALPET
District : KOMARAMBHEEM(ASIFABAD)
Pincode: 504296
9 e-Mail : krskrs1502@gmail.com
10 Mobile : 9704277557
11 Reservation Category : SC
12 Medium of Study in Class X : TELUGU
13 Category(General/Minority) : General
14 Group/Course Opted : BPC
15 Mention District by Study/Nativity : Adilabad
16 Reservation under Sports : No
17 Reservation under CAP(Childern of Armed No
Personnel) :
18 Are you a Physically Handicapped(PH) No
Person :
Qualification Details
19 Board : BOARD OF SECONDARY EDUCATION,T.S
20 SSC Hallticket Number : 1902108062
21 Examination Center : Hyderabad
22.Payment Details
Fee Amount Journal Number Payment Date
150 /- QCBI7420460080 09/04/2019
I hereby declare that
I read the information bulletin of TSRJC CET 2019 and found myself fully eligible to appear for the entrance test
as per the criteria mentioned in the bulletin.
I am appearing for Class X(2019) Public examinations as a fresh candidate(First attempt, not compartmental) and the
particulars furnished above are true to the best of my knowledge and belief.
Sd/-
KAMBALA PRANEETH
( 09-04-2019 02:54:53 PM )