‘Student's Personal Details Daksh; 11616064690 First Name Vivek Middle Ne Middle name Last Name Rai Full N (eperctassxie Vivek Ral Physically Disabled? * @No Aadhar C@4¥es — 7946070790 Date of Birth 2001-05-20 No : PAN Card* © Yes @No Gen@rmale O Female © Gen Photd®¥ ipaipes format of size upto (Passport S29PK0 allowed) school Kentiyfsisten ome seo tag a ot score mone Ea Communication Detalls (future communication wih you will be done through the email and mebile umber provided below Mobile91 6207683772 Email* _raivivek9900@gmall.com(itis i yhateneceased cconstiveauenmieny, Pradhuman Rai «) Father's EN Email (eapatieronn land nu ron OPER her and (Private employer (Buisness/shop/Selfemployed Labout/Group D Employee Unemployed (Retired Government Empioyee jother Father's Ac 40 Land Ownec Father land Hectare Craftsmen automation Designation ‘Annual Pension (/ (Tick fyate/Dereasad) Mothers FullIN! punita Rai (@onotadasaltaons tk, 6) Mother's ¢i.punita12@gmail.com VBovepiition aso pons cone BPA land (D}Farmer on other land (Private employee ([pBuisness/Shop/SelFemployed (Dlabour/Group D Employee maUheretored Father's Details, Father's Mobi 9631277955 Ec Class 12 lu * anguage oe English Hindi Other/Local Bhojpuri Fathers Ann | ess than 1.5 lakh Incom, Write Speak a a @ GB @ ieose mention actual income and nat he income mentioned inthe Income Certificate) Father's Ann’ 139999 Incom: Gro at fbggs® mention actual income and nat the 1 mention nth Income Cartes) (Prease wite Actual Income in figures. For 0000) Mother's Details Mother's Mébiil, 9162575134 Ec Post Graduate Language * English Hindi Read Write Speak 6 8 @ @ee eticed Government Employee other Mother's 39 Land Ownec Mother land Organization Designation Relation Name Age Brother Anurag kur | 15 Is/has been a Dakshana Scholar Yes No. Hectare Other/Local a Bhojpuri Annual Pen: 4 Mother's Annual In yer ncome mentioned nthe Income Certicte) Mother's Annual In ggg Prom aGg@8syeNTION Actual Income and tthe neome mentioned inthe Income Certificate) Sibling Info (Own brother & sister) Education Qualification Class 10 Current Occupation Monthly Income Marital Status Student Oarried m 5 @unmarried sibling i doing: Student, Gow. Employes, Private Employee, Business & Menton thir urent location. “For eg: Gow, Employee, etn) Other Adults in your household (Please mention details of grandparents/uncles living in your home only) Relation Name © Mother House No 336A shree ram bhawan bhalo ‘Age occupation Typical Monthly Income/Pension Who is your Guardian? Father Nearest | Bhagat medical store O other Address. Village * Gamabria Post Office* | GamahriaPa a cee State* Jharkhand Dist) Seraikela Kharsawan PinCode* 832108 Family Financial Information Total approximate value of all household assets* Less than 1 lakh 30000 Total earning members in the house* 01 a1 Total typical annual household income * Less than 2 lakh 130000 Total household cash savings* Less than 50 thot 20000 House Details Yourhouseis* © owned © Rented Monthly Rent* — 999 (ene) Number of Bedrooms 1 City/Town Type you live in * Do you belong to Below Poverty Line (GPL) Category? * Does your family hold a ration card? * Which of these does your family own? (Please Tick Appropriate) Name ‘Company/Model Name ‘Company/Model \Cable TV \Weshing Machine !2.Wheeler Air Cooler (4 Wheeter [Arr ConditionerTractor/Truck/Other )Microwave Vechile “Oven Fridge \Laptop/Desktop ‘School Details School Catt Central government School’ Jawahar Navodaya Vidyalaya & Applying®bengineering > Medical Annual School® 7200 Fees* Please provide Class X half yearly details if you are currently in Class X Class X Details Class X Board: CBSC Class X Roll 755389 (Mentor for JOST eandncny Maths %* 84 Science 86 “To convert GPA ander 0 point racing syste) to, plesse ly you Overall Age 89 (GPA with 9.5, For example, if our GPA is 92, then 9.2* 9.5 = 87.4%, Your (indusve o Soe Seences,Enlsh and Overal Aggregates 87.4 Resional Language) Test Preferences Test Center* JNV Ranchi Question Paper ®rst O#indi