Registration No.

: MTA23106719
MTA23106719
Personal Details
First Name Shardul
Middle Name Vikram Last Name Jaisawal

Father’s / Mother’s /
Shiv Prakash
Guardian’s Name

ID Name Aadharcard Date of Birth 26/08/2008

Id Number 952714630235 Gender Male
Nationality IndianCitizen Mobile No. 9458120261
Email Id shivprakash741@gmail.com

(I)
Alternative Alternative
7355290669 shardulvikaram41@gmail.com
Mobile No. Email Id
School Details
School Type KV School Name KENDRIYA VIDYALAYA GHAZIPUR
Class Tenth School Address Opium Facotory Mahua Bag
School Pincode 233001 School District Ghazipur

School State Uttar Pradesh Region Belong To Uttar Pradesh

Board CBSE Medium ENGLISH

TA
Address Details
Permanent Address Current Address
Door No. Kansapur Kendriya Vidyalaya
Street Maharaj Ganj Govt Opium Factory
Landmark Aurai Mahua Bag
City Bhadohi Ghazipur Sadar
District Sant Ravidas Nagar Ghazipur
State Uttar Pradesh Uttar Pradesh
M

Pincode 221314 233001

Subject IOQM Language ENGLISH

Centre Preference
Centre Name UPK0003 - kendriya vidyalaya ghazipur

Centre Preference 1 Centre Preference 2 Centre Preference 3

N/A N/A N/A

Payment Details
Amount 150 Transaction No 11000173964795

Transaction Date 13/07/2023 11:10:27 Status Success

Declaration
I hereby declare that the above statements are true and complete to the best of my knowledge and belief. In case of any changes in
the information furnished above, the same will be informed forthwith. In the event, the information is found to be false or incorrect
my application may be considered null and void.

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