JIPMER MBBS Form 2017 https://cdn.digialm.com/EForms/SBIAfterPayme...

Thanks for submitting your Application Form 4123 which can be used for all future
correspondence
Transaction No: IGABALXWT9
Amount: 1200.00

Personal Details

Application Number : 4123

Name of The Candidate: SHRISHTI SHADANGI

Father's Name: ARUN KUMAR SHADANGI

Mother's Name: MAMTA SHADANGI

Date of Birth: 01/01/1999

Whether OPH: No

Sex: Female

Nationality: Indian(Resident Indian National)

Puducherry resident: No

ID Proof: Aadhaar Card with Photograph

ID Proof No: 434313468466

Email ID: shrishtishadangi@gmail.com

Category: UR-Unreserved

Mobile No: 9039232363

Qualification Details

Status: Completed

Subject: Physics, Chemistry, Biology

Name of School/College: ST XAVIERS HIGHER SECONDARY SCHOOL

School/College City: BILASPUR

Name of the Board/University: Central Board of Secondary Education

Month of Passing: March

Year of Passing: 2016

Percentage: 74

Other Details

Parent's Educational Background: Father Graduate

Parent's/Gaurdian's Occupation: Other Professional Service

Parent's/Gaurdian's Specific Occupatio: BUSINESS

Parent's Annual Income: 2L to 3L

Present Address

Address Line 1: OPPOSITE OLD NISHANT POULTRY

Address Line 2: KASTURBA NAGAR

Address Line 3: JARHABHATA BILASPUR

State: Chhattisgarh

1 of 2 Monday 27 March 2017 11:57 AM