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  • RegistrationReceipt 210310028185

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    Anuz Saha
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    This document is a registration receipt for the Joint Entrance Examination (Advanced) 2021 for Agraz Saha, providing his personal details such as name, date of birth, category, address, academic details from Class XII, JEE (Main) scores, choices for examination city, and payment details for the registration fee. It also includes uploads of certificates and a declaration by the candidate agreeing to abide by the exam procedures and terms.

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    This document is a registration receipt for the Joint Entrance Examination (Advanced) 2021 for Agraz Saha, providing his personal details such as name, date of birth, category, address, academic details from Class XII, JEE (Main) scores, choices for examination city, and payment details for the registration fee. It also includes uploads of certificates and a declaration by the candidate agreeing to abide by the exam procedures and terms.

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    © All Rights Reserved
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    Flag for inappropriate content
    47 views1 page

    RegistrationReceipt 210310028185

    Uploaded by

    Anuz Saha
    This document is a registration receipt for the Joint Entrance Examination (Advanced) 2021 for Agraz Saha, providing his personal details such as name, date of birth, category, address, academic details from Class XII, JEE (Main) scores, choices for examination city, and payment details for the registration fee. It also includes uploads of certificates and a declaration by the candidate agreeing to abide by the exam procedures and terms.

    Copyright:

    © All Rights Reserved
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    of 1

    Joint Entrance Examination (Advanced) 2021

    Indian Institutes of Technology


    REGISTRATION RECEIPT

    Registration No. G51421050505


    Candidate Details
    JEE (Main) Application 210310028185 Date of Birth 27/02/2003
    No.
    Candidate's Name AGRAZ SAHA Category OBC- NCL (CENTRAL LIST)
    Mother's Name GOURI SAHA Person with Disability (PwD) As per No
    JEE(Main)
    Father's Name BISWAJIT SAHA Nationality INDIAN
    Complete Mailing Address
    Address BIJNI KUKLUNG ROAD WARD NO 1
    Country India
    State ASSAM District CHIRANG
    Locality Mobile Number 91-936****495
    City/Town/Village BIJNI Email Address sah*******@gmail.com
    Pin Code / Postal Code 783390 Additional Mobile No 91-700****325
    Land Line Number 700****325 Additional Email Address sah*********@gmail.com
    Academic details of Class XII (or equivalent) examination
    Year of Passing or Appearing 2020
    Name of the Class XII (or equivalent) examination INTERMEDIATE OR TWO-YEAR PRE-UNIVERSITY EXAMINATION CONDUCTED BY A RECOGNIZED BOARD/
    UNIVERSITY.
    School Board CENTRAL BOARD OF SECONDARY EDUCATION
    Roll Number 16617900
    Name of the School / College JAWAHAR NAVODAYA VIDYALAYA CHIRANG ASSAM
    Address of the School / College JAWAHAR NAVODAYA VIDYALAYA CHIRANG ASSAM
    JEE (Main) Paper 1 Score
    Physics: 95.5250190 Chemistry: 98.7815391 Maths: 79.6502876 Total: 95.8608356
    Remarks : Eligible for JEE (Advanced) 2021
    Furnished Information for JEE (Advanced)
    Need scribe/reader NOT APPLICABLE Do you want to avail extra time as of GoI NOT APPLICABLE
    guidelines/ memorandum
    Class XIIth (or equivalent)/ Qualifying India Year of First attempt in JEE (Advanced) 2021
    Exam (QE) Passed From
    Color Blindness No One Eyed Vision No
    Examination City for JEE (Advanced)
    1st Choice of Exam City ASSAM-GUWAHATI 2nd Choice of Exam City ASSAM-TEZPUR
    3rd Choice of Exam City ASSAM-JORHAT 4th Choice of Exam City ASSAM-DIBRUGARH
    5th Choice of Exam City ASSAM-SILCHAR 6th Choice of Exam City ARUNACHAL PRADESH-NAHARLAGUN
    7th Choice of Exam City NAGALAND-DIMAPUR 8th Choice of Exam City MEGHALAYA-SHILLONG
    OBC-NCL Certificate details
    Do you have a Valid OBC-NCL I have not been able to collect the said State / UT issuing the OBC Certificate ASSAM
    Certificate? certificate as of now. I will upload the
    Declaration in Lieu of OBC-NCL Certificate.
    OBC-NCL certificate will be uploaded by
    reporting at the time of JoSAA.
    OBC-NCL Caste / Community Sut, Soot
    Entry No. of OBC-NCL Caste / 21
    Community
    Payment Details
    Payment Mode SBI Internet Banking Transaction ID IGAMAHDIR2
    Registration Fee 2800 ( INR ) Date of Transaction 19-09-2021 23:18:32
    DECLARATION
    I hereby declare that all the particulars stated in this Registration Receipt are true to the best of my knowledge and belief. I have read and understood the JEE (Advanced)
    procedures. I shall abide by the terms and conditions therein. I understand that, if any of the information provided by me is found to be false / incorrect at any later time, my
    candidature shall be cancelled and I shall be debarred from appearing for JEE (Advanced).
    Images Uploaded by Candidate (During JEE (Main) Registration)

    Certificates uploaded
    Class-X or Birth Certificate Uploaded Class-XII (or equivalent) Mark Sheet Uploaded
    OBC-NCL Certificate Uploaded Additional OBC- NCL (CENTRAL LIST) Not Applicable
    Certificate
    PwD Certificate Not Applicable Scribe Request Letter Not Applicable
    DS Certificate Not Applicable PIO Card / OCI Card Not Applicable
    Compensatory Time Request Not Applicable Gazette notification showing the change of Not Applicable
    Letter name

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