L.P.

Sahi College, Patna

Admission Application Form
SESSION 2023-27, Application Year : 2024 [ SEM : 2 ] [Course : Social Science (Sem)-History]
Registration No : [ 202341200310 ] College Roll : [ 133 ]
1. Candidate Name : ANKIT KUMAR
2. Father's Name : MANTU SINGH
3. Mother's Name : GITA DEVI
4. Date of Birth : 01/01/2006 5. Gender : Male
6. Category : BC-2 7. Sub Category : Not Applicable
8. Nationality : INDIA 9. Aadhar : XXXX-XXXX-
10.Religion : Hindu 11. Minority :
12.Correpondance Add. : Village - Kaithi ; PS - Chautham ; District - Khagaria Bihar-851201
13.Permanent Add. : Village - Kaithi ; PS - Chautham ; District - Khagaria Bihar-851201
14. Mobile : 9608059008 15. Email : ankit960805@gmail.com
16.Payment Details : Rs. 3600 | Rec#165280 | Ref# 402066349834 | PayMode : Unified Payments | Remarks: Initiated but Interval Time
17.Payment Date : 20-Jan-2024 12:45:00
18.Subject Details : [MJC] History
[MIC] Political science
[MDC] Fundamentals of Human Resource Management
[AEC] Environmental Science
[SEC] Personality Development and Communication
[VAC] Constitutional Values and Fundamental Duties

Important Notes :
Please Double Check your Subjects and make sure your subjects are reflecting correctly.
You cannot select MDC-1 as your MDC-2, if selected, please contact college to get it changed.
Declaration

I declare that I fullfill all the criteria for admission in the above mentioned course in the college in the applied year. I
know, incase any of my information is found to be false or incorrect, it which will lead to termination of my admission at
any point of time during my course duration.

Signature of Parent/Guardian Signature of Candidate

Date : __________________