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NATA-2023
Online Application Form

Application Number : 70007262

Personal Details

Name of the Candidate MANAN NITIN MOMAYA

Father's Name Nitin Momaya
Mother's Name Jagruti Momaya
Guardian Name
Gender MALE
Date of Birth 28-Jan-2005
Category GEN
First Test (21 April 2023) & Second Test (28 May
Appearing for Test
2023)
Physically challenged No
Nationality Indian
Place of Residence SubUrban
Aadhar No 470929697865
ID Proof Aadhar
ID Proof Number 470929697865
HKF-63 Navodaya Housing Society
Communication Address Pundalic Nagar Nr Sanjay School
Alto Porvorim Goa

City Porvorim
Pincode 403521
State Goa
Phone No. (With STD Code) -
Mobile No. 8830242781
Email ID mananmomaya1738@gmail.com

Test Center Preferences

Test Center Preferences for Test 1(21 April 2023)

preference centre 1 Panaji

preference centre 2 Mumbai

preference centre 3 Pune

Test Center Preferences for Test 2(28 May 2023)

preference centre 1 Panaji

preference centre 2 Mumbai

preference centre 3 Pune

Details of Examination Passed

Institute
Roll
Name of the Pass Name of the Year of Total Marks % Name,
No/Enroll
Examination Status Board / University Passing marks Secured Secured address &
No
Pin Code
Goa Board Of Se
condary And Hig
Class 10th* Passed 2021 00 00 0 31266 403521
her Secondary E
ducation
Goa Board Of Se
condary And Hig
Class 12th* Appearing
her Secondary E
ducation

Payment Details

Payment Type : ICICI Payment Gateway

Transaction ID 230331146198409
Fee Paid (Rs) 4000.00
Status Success
Date 31-Mar-2023

Form filled On : 31-Mar-2023 18:27:48 Form printed On : 31-Mar-2023 18:27:51