Download as doc, pdf, or txt
Download as doc, pdf, or txt
You are on page 1of 2

Your Registration Number is : 500483

1. Course Applying for 2. Entrance Test Code 3.Date of Birth 4. Social Category Caste Certificate Attached 5. Sex 6. Name of the applicant 7-A. Qualifying Examination Applicable 7-B. Qualifying Examination 7-C. Year of Qualifying Exam. Passed / Appeared 8. Whether Hostel Facility is required ? 9. Test Centre Code 1st Preference 2nd Preference 10.Whether applying for more than one Test Codes 11. E-mail 12. Name (In Block Letters) 13. Address 14. Pin Code 15. Phone No. 16. Mobile No. 18. Father's Name 19.Mother's Name 02 - BHOPAL 01 - SAGAR No avadheshb@gmail.com AVADHESH BHARDWAJ 861 DWARKAPURI INDORE Madhya_Pradesh 452009 07312542013
8109461061

PG 224 - M. Pharm. 1986-04-28 Age : 24 General N/a Male AVADHESH BHARDWAJ


Fix Your Passport Size Photo

3. B.Pharna/GPAT Passed 2009 Yes

HRIDYESH BHARDWAJ KALPANA BHARDWAJ

20. Select the course for UGET as per the following . Separate Applications is compulsory for each UGET Test Code.

Demand Draft Details

Name and address of the issuing Bank Date of issue DD / Bank Pay Order Number Amount

30129 STATE BANK OF INDIA, PARDESHIPURA, INDORE 06/04/2011 038369 650.00

You might also like