Odisha Joint Entrance Examination - 2020 for B.

Pharmacy/ INTEGRATED MBA(5YEARS)

Confirmation Page

Application No. 2001 0001 577 -

DO NOT SEND THIS PAGE TO BOARD.
CANDIDATE IS REQUESTED TO RETAIN THE PRINTOUT OF ACKNOWLEDGEMENT PAGE FOR FUTURE REFERENCE.

Personal Section
Candidate's Name ANIRUDHA CHOUDHURY Date of Birth 06-04-2002
Mother's Name LOPAMUDRA CHOUDHURY Birth Category General
Father's Name KRUSHNA CHANDRA CHOUDHURY Gender Male
Physically Challenged No Sub Category Not Applicable
Nationality Indian Annual Family Income Less or Equal to 8 Lakhs
Domicile ODISHA Have you applied for Women NA
Reservation?

Applying For
Apply For PHARMACY AND INTEGRATED MBA BOTH Exam City 1st ODISHA - Cuttack (015)
(32)
Exam City 2nd ODISHA - Bhubaneswar (014) Exam City 3rd ODISHA - Balasore (010)

Education Details
Qualification Pass Status Course/Stream Board/University Year of Result Marks Detail RollNo/ Institute Pincode
Name Name Passing/appe Mode Enroll Name &
aring No. Addres
s
12th or Appearing 10+2 Science CENTRAL BOARD OF 2020 NA NA 1260337 LR DAV 753003
equivalent SECONDARY 4 PUBLIC
EDUCATION SCHOO
L,CUTT
ACK

Contact Details
Address AT BERHAMPUR ,PO SIRLO NABAGRAM Locality VIA RAGHUNATHPUR
City/Town/Village CUTTACK District CUTTACK
State ODISHA Pin Code 754132
Email Address jch***********@gmail.com Mobile Number (+91) 943****735
Land Line No. with --
STD code or any
other Contact No.

Fee Payment Details

Payment Mode: Pay through SBI(MOPS) Transaction ID: IK0ALNTBA7
Exam Fee: 1000 /- Date of Transaction: 12-02-2020 2024:59:49
Fee Submitted On: 12/02/2020
DECLARATION
I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. I have read and understood the Board
procedures. I shall abide by the terms and conditions thereon.

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