127312019 NEET- 2020 Confernation Page for Application Number 200410903572

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CONFIRMATION PAGE - NEET (UG) - 2020

Mpplication No. (200410493572

pomit ax s (Candidate’s Name) 'SHAMSHER SINGH faem ff (Date of Birth) {22/06/2002

0 98 AT (Moehur's Mame) KULWINDER KAUR I!In (Gandar) Male

Fx w2 (Pather's Name) BALIET SINGH 7 (catagoey) sc
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NI S 1ng Class: 2020 m withy Dtjubluv (PWON disabiinty s [Ne
11/Quadying Exam )
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AE W NN (Medium of Question enplieh T e GV (% of Marka obtaned (n L

agar))# [Class 12\Qualifying Examination)
Wt (Mol No.) O Luxnxxn0ROL e et (Himalt Aodrens) [prnrunsugmeti.com
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fe1) Ammrvsan ¢ 3w01) k)wum) (3) LUDMIANA ( 3804) Ekflufimwm

DECLARATION: - | hereby atfem that all the particubirs stated by me in the ADBHCaon FOrm ire Ui and correct. Even e apeiiog of names 310 cotugory
Are a0 comact. [ have rot concenled any Information, Howaver, & hey INfOrmation fumsned heroin & found fraudulent, Incomect or untrue, | will be lable for
N Provetution which Wil resut in cancallation of my candidatura, Further that tha solection and sdmistion o tha cours s lable to bo cancalied. | agreo
to abide by thy Rulos And Reguintions governng tik Exaination a6 containad in the Information Butatin for NEET (UG] - 2020 which 1 have gone through
Coratulty. 1 Tunthar declive Uhat | have not submitted any othar opplication for NIET (UG) 2020 and iobile numbier and sl addness givin i he farm are
COMRCL
And vy own or of My Parents.

aa? (N
et Signature
| Left Hand Thumb Imprassion
HAMSBHER SINGH
26-12.2019
Photo

!Dnu of Transaction: 31/12/2019

Printed On : 33/ 12/2019 03:35:32

Caredotz's Name, Mother's Hame. Father 3 Hame, Date of Buth, Gerder, Categery, PaD, Cheice of Exsrnmstion Cities and Medium ol Qacition baper. Ln case of soy
dicrepnncy, these may pleate be comweind dursng 15th Maruiry, 2020 1o 31t Jevary, 2020 No corractions shall bo alowed under any cireumtances afler Whis dite,

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