10/29/24, 3:10 PM CENTAC - Govt.

of Puducherry

CENTRALISED ADMISSION COMMITTEE

Government of Puducherry
UG NEET APPLICATION FORM FOR ONLINE CENTAC ADMISSION - 2024 - 25

APPLICATION NUMBER : 62405858

Personal Data
Applicant's Name SHIVAMAYI JAYAKUMAR

Father's / Guardian's Name JAYAKUMAR C

Mother's Name SRIJA JAYAKUMAR

Gender Female

Date of Birth 23/10/2004

Religion Hindu

Mother Tongue Malayalam

Address Details
Email ID [email protected]

Mobile Number 7306711741

Alternate Mobile Number 8089922799

Permanent Address Sreelakam, Kaniyapuram P.O, Pallipuram, Thiruvananthapuram,695301

Communication Address Sreelakam, Kaniyapuram P.O, Pallipuram, Thiruvananthapuram,695301

Aadhar Number 476173200979

Reservation Details
Nationality INDIAN

Residence Other States

Community / Category GENERAL NRI Sponser

Special Reservation Details

Applied Quota Details

Applied Quota Management/Self Supporting Only

NEET Details
NEET Application Number 240410979421

NEET Year of Passing 2024

NEET Roll Number 9901010045

NEET All India Rank for Counselling 774659

NEET Mark Secured 249

NEET Maximum Mark 720

Academic Details
HSC Board Name Kerala State Board

Stream Name Academic

HSC Registration Number: 22115282

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Number of attempts 1

Result: Pass

Whether H.Sc. completed in Open School (NIOS No

or Other Open Schooling):

Whether H.Sc. exam written as Private candidate No

(Exam Not attended through the School):

Biology / Bio-Technology studied as OPTIONAL No

subject in H.Sc. or its equivalent:

Class School Name Type Year of Passing

12th KRISTU JYOTI Higher secondary school Govt aided 2023

11th KRISTU JYOTI Higher secondary school Govt aided 2022

10th GULF INDIAN SCHOOL , KUWAIT Private 2021

9th GULF INDIAN SCHOOL , KUWAIT Private 2020

8th GULF INDIAN SCHOOL , KUWAIT Private 2019

Marks
Subjects ENGLISH FRENCH PHYSICS CHEMISTRY BIOLOGY MATHEMATICS
/
MATHEMATICS
I

Marks 192 / 200 193 / 200 175 / 200 179 / 200 188 / 200 170 / 200

Secured Mark / Maximum Mark 1097 / 1200 Result : Pass

Payment Details
Reference Number N2024102913013707622

Amount 2000.00

Pay Date 2024-10-29 01:05:35

Attachments
Attached File Uploaded View

Birth Certificate YES Birth Certificate

HSC Marksheet YES HSC Marksheet

Tenth Marksheet YES Tenth Marksheet

Transfer Certificate YES Transfer Certificate

NEET Score Card YES NEET Score Card

COURSE PREFERENCE - STRAY Last update: 2024-10-29 14:02:42

1 [MQ] (MINDS, PDY) - B.D.S. Dental

2 [MQ] (MGPGIDS, PDY) - B.D.S. Dental

3 [MQ] (SVDC, PDY) - B.D.S. Dental

Declaration
 I hereby declare that I have carefully read the UG NEET Information Brochure. All the particulars stated in this application
form are true and correct to the best of my knowledge and belief. If any information provided is found false/ incorrect, I shall
abide by the actions and decisions taken by the CENTAC.

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Signature

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