University of Rajasthan

Admission for various disciplines

PRINTED APPLICATION FORM

Application No / Form No PH-1/2023/105459

Candidate Name RISHITA BHARDWAJ

Contact Number 9057504410

Email Id RBHARDAWAJ2002@GMAIL.COM

Subject 1 ZOOLOGY
Subject 2 CHEMISTRY
Subject 3 ANTHROPOLOGY

Father's name HEMANT KUMAR SHARMA

Mother's name SANTOSH
Date of birth 19-03-2003
Gender FEMALE
Category EWS
Aadhar Card Number 682175835661
Whether belong to Special Category? NO
Whether belong to Kashmiri Migrant? NO
Are you Victim of Jaipur Bomb Blast? NO
Weightage Concession Category? NO
Correspondence Address

Address Adarsh nagar,ward no 37 College road, gangapur city

State rajasthan
District sawai-madhopur
Pincode 322201
Permanent Address

Address Adarsh nagar,ward no 37 College road, gangapur city

State rajasthan
District sawai-madhopur
Pincode 322201
EDUCATIONAL DETAILS
 Name Of Max Marks Or Obtained Marks Or Percentage
Name Of Examination Year
Board Grade Grade CGPA
10th BSER 2018 600 443 73.83

12th BSER 2020 500 377 75.40

Graduation UOK 2023 2025 NA NA

Any Other
Qualification

PAYMENT DETAILS
Reference Number Amount Response Code Payment Mode Status Transaction Date
20230622212345990 1100() E006 UN-SUCCESS

Declaration:
1. hereby undertake that I have carefully gone through the eligibility conditions prescribed in the notification
for entrance test and course to which I have applying and shall appear in the eligibility test after satisfying
myself that I fulfill the same.

2. I know that if I do not eligibility rules of admission and if any information provided by me is found to be
incorrect at any stage, the University of Rajasthan has the right of cancel my candidate/ admission.

I, do hereby declare that all the statements made in this application are true, complete, correct to the best of
my knowledge and in the event of any information being found false, incomplete, incorrect or concealing the
fact, my candidature may be cancelled at any stage without any notice and without assigning any reason
thereof even after selection.

Application Submission Date : 22-Jun-2023

Scanned Signature of Candidate

THE INFORMATION FURNISHED IN THE APPLICATION FORM AND ORIGINAL CERTIFICATES WILL, HOWEVER,BE
SCRUTINIZED / VERIFIED AT THE TIME OF DOCUMENT VERIFICATION