ODISHA UNIVERSITY OF AGRICULTURE & TECHNOLOGY

APPLICATION FORM-A
FOR ADMISSION INTO UNDER GRADUATE COURSES - 2020

Applicant Details

Applicant Name ANIRUDHA CHOUDHURY Application No. ACK01005990

UIDAI Type Aadhaar Number UIDAI Number 270418595883

Mother's Name LOPAMUDRA CHOUDHURY Father's Name KRUSHNA CHANDRA CHOUDHURY

Date of Birth 06/04/2002 (Age as on 31.12.2020) 18 Years 8 Months 25 Days

Gender Male Religion Hindu

Blood Group AB+ Parents Annual Income 5 Lakhs to 10 Lakhs

Category UR Mother Tongue Odia

Nationality INDIAN Email jchoudhury8494@gmail.com

Mobile Number 9437087735 Alt. Mobile No. Not Available

Present Address Permanent Address

AT BERHAMPUR PO SIRLO NABAGRAM VIA AT BERHAMPUR PO SIRLO NABAGRAM VIA

Address Address
RAGHUNATHPUR RAGHUNATHPUR

District Cuttack District Cuttack

State Odisha State Odisha

Country India Country India

Zip Zip
754132 754132
Code Code

Domicile Information

Has the Candidate passed Odia as one of the Subject in HSC entrance Exam from any School/Institute of Odisha? No

Residence Type Domicile of odisha

Choice of Center

First Choice Cuttack Second Choice Bhubaneswar Third Choice Jagatsinghpur

Payment Details

Payment Date Reference No. Receipt No. Amount (₹) Status

28/02/2020 TXOUA280220200007236 RTOUA280220200006144 1400.00 Payment Made Successfully.

Declaration

I, ANIRUDHA CHOUDHURY do hereby declare that the information submitted by me in the application is true to the best of my knowledge and belief.
I have applied for OUAT UG admission 2020 with the consent of my Parents and Guardians.