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1. The document appears to be an entrance registration form for Mahatma Gandhi Kashi Vidyapith's B.Sc. (Biology) program. 2. It contains information about the applicant such as name, date of birth, gender, caste, academic qualifications, payment details. 3. The applicant declares that she has never been convicted of a criminal offense or disciplinary action, and understands the university rules for admission.

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2014rajpoint
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64 views

$RR38CCM

1. The document appears to be an entrance registration form for Mahatma Gandhi Kashi Vidyapith's B.Sc. (Biology) program. 2. It contains information about the applicant such as name, date of birth, gender, caste, academic qualifications, payment details. 3. The applicant declares that she has never been convicted of a criminal offense or disciplinary action, and understands the university rules for admission.

Uploaded by

2014rajpoint
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Mahatma Gandhi Kashi Vidyapith, Varanasi There are

SESSION 2023 - 2024 invalid


Entrance Registration Form characters in
the text
106 - B.Sc. (Biology) [SF]
Form No. : 23G0006121-05573 Date : 15 May, 2023 06:00 PM

1. Candidate's Name : BHAWANA SAHANI


2. Father's Name : RAJNATH SAHANI
3. Mother's Name : KANCHAN DEVI
4. Date of Birth : 06-Sep-2007 5. Gender : FEMALE
6. Caste/Category : O.B.C. 7. Sub-Category : महिला

8. Caste Certificate #: 672223015938 9. Income Grp : Less than 1 Lac per annum
10. Domicile : Uttar Pradesh 11. Religion : Hindu
12. Domicile Cert. #: 13. Minority : NO
14. Nationality : INDIAN 15. Other Cat. : Not Applicable

16. Hostel Required?: No 17. EWS Status : Does not belong to EWS

18. AADHAAR No.: 611X-XXXX-X159 19. N.A.D. No. :

20. Address for Correspondance :


SHANTI PURAM COLONY
Varanasi

L 21. Permanent Address :


RAMNA
Varanasi
NA
Uttar Pradesh Uttar Pradesh
PIN Code : 221011 PIN Code : 221011

22. Mobile : 84XXXXX922 23. Email : moh*****@gm***.com

24. Academic Record : 25. 10th Marksheet Serial Number: 2996605


Examination Year Max Obt. Roll No. Stream Board %
Highschool 2021 600 457 212383744 N/a U.P. Board of High School & Intermediate 76.17
Education, Allahabad.
FI

Intermediate 2023 500 376 2237075994 Science (Biology U.P. Board of High School & Intermediate 75.2
Group) Education, Allahabad.

Printed: Monday, May 15, 2023 07:24 PM Page: 1/2


Mahatma Gandhi Kashi Vidyapith, Varanasi There are
SESSION 2023 - 2024 invalid
Entrance Registration Form characters in
the text
106 - B.Sc. (Biology) [SF]
Form No. : 23G0006121-05573 Date : 15 May, 2023 06:00 PM

26. Payment Details: Payment date : 15-May-2023 | PG Ref# 17364562419 | Amount : 650.00

27. Weightages Claimed :

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
Date:

L Signature of Candidate
Date:
NA
FI

Printed: Monday, May 15, 2023 07:24 PM Page: 2/2

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