Patliputra University, Patna

Under-Graduate (UG) Admission Application Form

SESSION 2023
UAN # 23G0003934 Appl. Date : 23 May, 2023 10:40 AM

1. Candidate Name : DHANANJAY KUMAR

2. Father's Name : RAMJEE KUMAR
3. Mother's Name : KIRAN DEVI
4. Date of Birth : 16-Mar-2006 5. Gender : MALE
6. Category : General 7. Sub Category : Not Applicable

8. Other Category : Not Applicable 9. AADHAAR : 70*******720

10. Domicile : Bihar 11. Dom. Cert. : BRCCO/2023/1064067
12. Religion : Hindu 13. Minority : NO
14. Nationality : INDIAN 15. EWS Status: Not Applicable/No EWS

16. Address for Correspondance : 17. Permanent Address :

Vill - Kajur, PO - Kajur, PS - Atri, Gaya Vill - Kajur, PO - Kajur, PS - Atri, Gaya
Gaya Gaya
Bihar Bihar
PIN Code : 805131 PIN Code : 805131

18. Mobile : 7857844038 19. Email : dhananjaykumar16031603@gmail.com

20. Payment Details: Paid Rs.300.00 on 25/5/2023 Ref# 2199866497912 Bank Ref: UPI - 314587652689
21. Qualifications

Examination Board/University Year Roll No. Max. Mrk. Obt. Mrk.

Highschool C.B.S.E. (Central Board of Secondary Edu. 2, Commu... 2021 22161140 500 425
21206230100
Intermediate Bihar School Exam. Board, Sinha Library Road, Patna 2023 500 352
62
Subjects/Stream : Science

Subject Obtained Marks Max Marks Percentage %

English 79 100 79.00
Hindi 80 100 80.00
Physics 64 100 64.00
Chemistry 61 100 61.00
Mathematics 68 100 68.00
Other Qualifications

22. Quota Selection

23. College/Course Chosen (in order of preference)

Pref# College Degree Subject

1 [231] Government Degree College, Rajgir, Nalanda B.Sc. Mathematics (Major) Mathematics
2 [214] Nalanda College, Biharsharif B.Sc. Mathematics (Major) Mathematics
3 [210] Kisan College, Nalanda B.Sc. Mathematics (Major) Mathematics
4 [223] S.P.M College, Nalanda B.Sc. Mathematics (Major) Mathematics
5 [224] S.U. College, Hilsa B.Sc. Mathematics (Major) Mathematics
Printed: Wednesday, July 5, 2023 04:23 PM Page: 1/2
 Patliputra University, Patna
Under-Graduate (UG) Admission Application Form
SESSION 2023
UAN # 23G0003934 Appl. Date : 23 May, 2023 10:40 AM

Pref# College Degree Subject

6 [225] T.P.S College, Patna B.Sc. Mathematics (Major) Mathematics
7 [218] Ram Krishna Dwarika College, Patna B.Sc. Mathematics (Major) Mathematics
8 [205] College of Commerce, Arts and Science, Patna B.Sc. Mathematics (Major) Mathematics
9 [412] L.P. Sahi College, Patna B.Sc. Mathematics (Major) Mathematics
10 [414] Magadh Mahavidyalaya, Chandi, Nalanda B.Sc. Mathematics (Major) Mathematics
11 [416] Nalanda Sodh Sansthan, Biharsharif, Nalanda B.Sc. Mathematics (Major) Mathematics
12 [423] R.L.S.Y. College, Biharsharif, Nalanda B.Sc. Mathematics (Major) Mathematics
13 [430] S.P. College, Hilsa B.Sc. Mathematics (Major) Mathematics
14 [231] Government Degree College, Rajgir, Nalanda B.Sc. Physics (Major) Physics
15 [214] Nalanda College, Biharsharif B.Sc. Physics (Major) Physics
16 [210] Kisan College, Nalanda B.Sc. Physics (Major) Physics
17 [223] S.P.M College, Nalanda B.Sc. Physics (Major) Physics
18 [224] S.U. College, Hilsa B.Sc. Physics (Major) Physics
19 [225] T.P.S College, Patna B.Sc. Physics (Major) Physics
20 [218] Ram Krishna Dwarika College, Patna B.Sc. Physics (Major) Physics
21 [205] College of Commerce, Arts and Science, Patna B.Sc. Physics (Major) Physics
22 [412] L.P. Sahi College, Patna B.Sc. Physics (Major) Physics
23 [414] Magadh Mahavidyalaya, Chandi, Nalanda B.Sc. Physics (Major) Physics
24 [416] Nalanda Sodh Sansthan, Biharsharif, Nalanda B.Sc. Physics (Major) Physics
25 [423] R.L.S.Y. College, Biharsharif, Nalanda B.Sc. Physics (Major) Physics
26 [430] S.P. College, Hilsa B.Sc. Physics (Major) Physics

Declaration

I declare that I have never been convicted for any criminal act and that there is no case pending
against me in the court of law. I also declare that I have never been caught using Unfair Means or
any Disciplinary action has been taken against me. If I was charged for using Unfair Means, the
punitive duration is over and charges have been cleared. I have read carefully and have understood
all rules as mentioned in the University Rules and Admission Brochure. Furthermore I also declare
that if my application is found to contain incorrect/false information regarding my Name, Birth Date,
Gender, Religion, Domicile, Weightage, Caste, Horizontal Reservation, Marks obtained or any other
field, my application is liable to get cancelled, and I will have no objection in getting disqualified for
admission to the concerned course/college.

Signature of Parent/Guardian Signature of Candidate

Date: Date:

Document Checklist
NOTE: Mark the number of documents ( Photocopy/Xerox) attached by the Candidate during form submission to the college

Xth Marksheet Xth Certificate

XIIth Marksheet Last Exam Passed Marksheet
Recent Passport Sized Photograph Scanned Signature
Domicile (for other state) Certificate for Kashmiri Resident
Certificate for Category Certificate for Sub-Category
Documents for Claiming Weightage Other Certificate/Document

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