5/0122, 3:01 PM les hitps/ig01igialm com/EForms/BillDeskWhHMACAerPaymentAction do?formOraType= Registration Details IPM Admission Form 2022 NOTE: Your Application form is Submitted Successfully Personal Details Application Number 12214994 Name of Candidate PRIYANSHA PRACHI Mother's Name SARIKA DEVI Gender Female Date of Birth 01/May/2004 Ni tionality Indian Mobile Number 91 6369794472 Father's/Guardian’s Name PRITESH RAJU Category General Person with Disabiliy (PWD) No Email Address priyanshaprachi@gmail.com Country of Residen India 18549221329ZZonIine 185/0122, 3:01 PM Communication Address Address (ine 1 P-34, 5, coast guard residential, ngo colony, 4th street State/Union Territory TAMIL NADU incade 600061 Email Address(Alternate) arshraj80@gmail.com IPM Admission Form 2022 Address Line 2 meenambakkam, chennai-61 Vilage/Town/City Chennai Moolle Number(Akernate) 8356882360 Standard X / SSC / Equivalent Examination Details SSC Year of Completion 2020 Standard x. Name SSC / Equivalent Exarrination Board Central Board of Secondary Education Standard xl / HSC / Diploma/ Equivalent Details Have you completed Standard Xll/ HSC Diplomal Equivalent Course No Standard Xll/ HSC ‘Equivalent Board Name Central Board of Secondary Education am / Discipline hitps/ig01igialm com/EForms/BillDeskWhHMACAerPaymentAction do?formOraType= Aggregate Marks in percentage(Upt0 2 decimal places) 77.60 School Name KV DGQA Course Type XIl/ Equivalent schoolinstute Name ARMY PUBLIC SCHOOL 86492219297Z0nIne 205/0122, 3:01 PM IPM Admission Form 2022 Commerce Exam Centre City Preferences Preferred City 1 Preferred City 2 Chennai Bangalore Preferred City 3 Preferred City 4 Patna Ranchi Preferred City § Kolkata Payment Details ayment mode Payment status online Payment Success Payment amount Payment transaction no. 4130 WHMP1134345932 Candidate Documents/Images Upload Details Signature Version 14.04.01 hitps/ig01igialm com/EForms/BillDeskWhHMACAerPaymentAction do?formOraType= 18549221329ZZonIine 38