UNIVERSITY OF LUCKNOW

Online Application Form for Admission - 2021

(Undergraduate Programs)
REGISTRATION ID : 20211048882

PERSONAL DETAILS
Name of Programme : B.A.
Name of Student : RAGINI KANAUJIA
Father's Name : PAPPU KUMAR RAM
Mother's Name : POONAM DEVI
Date of Birth : 05/01/2004
Mobile Number : 9335638093
E-Mail ID : raginikanaujia953@gmail.com
Gender : Female
Domicile : Uttar Pradesh
Religion : HINDU
Category : SC Caste Certificate Numbe : 636204001011
Annual Income of
: Below 200000.00 Nationality : Indian
Family (in Rs.)
Sub category : -
Weightage : - Zero Fees Required : No
Father's Income below Rs. 2,00,000 Per Annum : Blood Group : O+
ID Proof : Aadhar Card ID Number : 758299638967

ADDRESS FOR CORRESPONDENCE PERMANENT ADDRESS

Address : 15 KAMLA NEHRU NAGAR KAMTA CHINHAT Address : 15 KAMLA NEHRU NAGAR KAMTA
LUCKNOW CHINHAT LUCKNOW
Lucknow - 226028 Lucknow - 226028
Uttar Pradesh, India Uttar Pradesh, India
Mobile Number : 9335638093 Mobile Number : 9335638093
Alternate Mobile Number : 8858983381 Alternate Mobile Number : 8858983381
Landline With STD Code : - Landline With STD Code : -

EDUCATIONAL QUALIFICATION
HIGH SCHOOL OR EQUIVALENT EDUCATION

Roll Number : 5092342 Passing Year : 2019 Percentage : 81.80%

Maximum Marks : 500 Marks Obtained : 409
Examination Body of the High School or equivalent Education : C.B.S.E. Board

INTERMEDIATE/POLYTECHNIC OR EQUIVALENT EDUCATION

Roll Number : 23637179 Passing Year : 2021 Percentage : 82.40%

Maximum Marks : 500 Marks Obtained : 412
Examination Body of the Intermediate or equivalent Education : C.B.S.E. Board
SUBJECT-WISE MARKS OBTAINED IN INTERMEDIATE
BIOLOGY(80/100),CHEMISTRY(79/100),ENGLISH CORE(85/100),PHYSICAL EDUCATION(89/100),PHYSICS(79/100)

PAYMENT DETAILS
Amount (Rs.) : 400.00 Transaction No. : ADM210000115317 Transaction Date : 15/07/2021

DECLARATION : All the Information entered by me in the Application Form are true to the best of my knowledge . If at any stage of the admission
process any information is found to be wrong I will be fully responsible for this and my application or candidature may be rejected.

Signature of Student
N O T E : K i n d l y k e e p t h e p r i n t o u t o f t h e A p p l i c a t i o n f o r m w i t h y o u . Yo u h a v e t o b r i n g t h e p r i n t o u t o f t h e A p p l i c a t i o n F o r m o n l y a t t h e
time of Counselling. Do not send any printout to the University of Lucknow by post or by hand.

Print Date : 09/09/2021 Page 1 of 1