Online Registration For MH-Nursing-CET-2024 Application Form

GOVERNMENT OF MAHARASHTRA
STATE COMMON ENTRANCE TEST CELL, MAHARASHTRA STATE
8th Floor, New Excelsior Building, A.K.Nayak Marg, Fort, Mumbai-400001. (M.S.)

Application Form for Online Registration For MH-Nursing-CET-2024

Application No. : 249177883 Version No : 1

Personal Details
Candidate's Full Name MAHALE DARSHANA MADHUKAR

Father's Name MADHUKAR

Mother's Name SUMITRA

Gender Female

Marital Status UnMarried

Spouse's Name -

Date of Birth 31/10/2006

Religion Hindu

Region Rural

Mother Tongue Marathi

Annual Family Income 15,001 - 50,000

Nationality Indian
MH-Nursing-CET-2024 Application Fee Paid (Rs . ) 800/-
Permanent Address Address for Correspondence
Address Line 1 At-Behedgaon Taluka-Jawhar District-Palghar Address Line 1 At-Behedgaon Taluka-Jawhar District-Palghar
Address Line 2 At-Behedgaon Taluka- Jawhar District-Palghar Address Line 2 At-Behedgaon Taluka- Jawhar District-Palghar
Address Line 3 -- Address Line 3 --
State Maharashtra District Palghar State Maharashtra District Palghar
Taluka Jawhar Village Behadgaon Taluka Jawhar Village Behadgaon
PIN Code 401603 PIN Code 401603
Telephone No - 7350770166
Domicile and Category Details
Are you Domiciled in the State of Maharashtra? Yes
Category ST
Belongs to Caste Kokna
Do you possess Caste Certificate Available
Do you possess Caste Validity Not Applied
Are you Person With Disability ? No
Belongs to Minority Category No
Linguistic Minority NA
Religious Minority NA
Orphan Details
Are you Orphan? No
Qualification Details
SSC / Equivalent Details
SSC/Equivalent Passing Year 2022
SSC/Equivalent Percentage 76.00
SSC/Equivalent Board Maharashtra State Board of Secondary and Higher Secondary Education, Pune
State From Which you Passed SSC/Equivalent Maharashtra
HSC / Equivalent Details
Are you Appearing /Appeared 12th (HSC) exam in 2024 Yes
HSC/Equivalent Board Not Applicable
MH-Nursing-CET-2024 Examination Details
State for MH-Nursing-CET-2024 Examination Center Maharashtra
Examination Center District at Preference Number 1 Nashik
Examination Center District at Preference Number 2 Palghar
Examination Center District at Preference Number 3 Thane
Examination Center District at Preference Number 4 Mumbai City
Document Uploaded
Sr. No. Document Name
1. Aadhaar Card
Note :
• You are required to Upload the Caste Certificate clearly mentioning the Category of the Candidate and also the remarks that the Caste is
recognised as backward class in the State of Maharashtra at the time of Centralised Admission Process(CAP 2024).
• You are required to Upload the Caste / Tribe Validity Certificate in the name of the Candidate, issued by the caste validity committee of
Maharashtra State at the time of Centralised Admission Process(CAP 2024).

Declaration :
I MAHALE DARSHANA MADHUKAR have downloaded the Information Brochure of MH-Nursing-CET-2024 and have read all the rules for
appearing the CET and on understanding these Rules, I have filled this Application Form for appearing to MH-Nursing-CET-2024 for the
Academic Year 2024-25. This information given by me in this application is true to the best of my knowledge & belief. If at later stage, it is
found that I have furnished wrong informatation and/or submitted false certificate(s), I am aware that my admission stands cancelled and fees
paid by me will be forfeited. Further I will be subject to legal and/or penal action as per the provisions of the law.
Date : 01/03/2024

Last Modified By : 249177883, 152.58.23.82, 162.158.22.245:62142

Last Modified On : 01/03/2024 7:52:36 PM

Signature of Applicant
Printed On : 01/03/2024 7:53:05 PM (MAHALE DARSHANA MADHUKAR)