Universitywhich may include cancellation of admission and any other punishment/action taken by the Universityin such

eventuality.

Application Form for UG - 2021

Application ID 44012
Candidate's Full Name Fozia Khalil

Date Of Birth Gender Category

Residents of Backward Area (RBA)
Tuesday, April 23, 2002 Female
/ EWS category
Phone Email Aadhaar Number
6005705283 marmani935@gmail.com 961908653257
Alternate Phone Alternate Email Blood Group Candidate Photograph

A positive

Father's Name Mother's Name

Khalil Ahmed Shanaz Akhter

Parent / Guardian Email Parent / Guardian Phone

foziakhalil570@gmail.com 9086311192
Candidate Signature
State Of Domicile Applying As
Jammu And Kashmir / Ladakh Jammu And Kashmir / Ladakh Candidate
Physically Challanged Disability Description
NO NA

Center Choice Stream Code

Jammu 01 PCB
Academic Details of 12th
University / Institute Roll Number Year Of Passing / Appearing Aggregate Percentage Candidate Thumb Impression

JKBOSE 4504721 2019 60.60

Marks BreakUp
English Physics Chemistry Biology Math
49.00 69.00 57.00 60.00 0.00
Payment Status Payment Date Payment Amount Payment Status
Paid Tuesday, August 10, 2021 8:51:14 PM 1500.00 INR WHMP0186487006

DECLARATION :
N.B:- N.B:- The Inservice candidates are necessarily required to have nomination letter / NOC from there concerned
employer at the time of RAA / Counselling..

Certificate: I certify that the above particulars are true and correct to the best of my knowledge. If at any time it is
revealed that any of the entries given is wrong and incorrect, I shall be held responsible for any action taken by the
Universitywhich may include cancellation of admission and any other punishment/action taken by the Universityin such
eventuality.