PT. B. D. SHARMA UNIVERSITY OF HEALTH SCIENCES, ROHTAK.

SWAMI DEVI DYAL HOSPITAL & DENTAL

COLLEGE,GOLPURA,PANCHKULA (Code : 9223)

BACHELOR OF DENTAL SURGERY (B.D.S.) (SECOND YEAR) SUPPLI. -

DEC-2021 (Code : 8015)

Online Application Form - Login Id : 1096383

Candidate's Name: JUNAID KHAN

Father's Name: AKBAR KHAN
Mother's Name: NASIM AKHTAR
Date of Birth: 26/06/2000

Gender: Male
Category: General

Email Id: 16junaid@gmail.com

Mobile No.: 9416303330
Aadhar No.: 369347141551
Address: CHHAPAR, CHHAPAR, JIND, Jind (Haryana (HR)) - 126112

Previous Examination Details:

Exam Name Year Roll No. Overall Marks Status

College Reg. No.: 19-SDDI-129

Old Roll No.:
Medium: English
Subjects: 1. BD06
Fee Details: Order Id : 1236051, Transaction Id : b4846728cd03ff53db0d
Amount : 2500.00, Date : 1/8/2022 1:58:11 PM

Print Date & Time : 08/01/2022 01:58:53 PM

Place : Signature of the Candidate
I Certify that the candidate mentioned above has satisfied me by production of authentic documents, that the statements made by him /
her above are correct, that he / she has fulfilled the conditions laid down under the regulations for eligibility to appear in the
Examination mentioned above in force in the Pt.B.D. Sharma, University of Health Sciences, Rohtak and that he / she bears a good
moral character.

Seal and Signature

Director / Principal / Head of the College / Institution