COMMON ENTRANCE TEST

(CET- 2021)
ONLINE APPLICATION FORM

Application No: 200392

Applied Level: UG

Candidate's Name: PRIYANSHU BHAKTA

Father's Name: SWADESH BHAKTA

Gender: MALE

Category: GENERAL

Physically Challenged: NO

Date of Birth: 07-07-2003 Nationality: INDIAN

Mobile Number: 8250745505 Parents/Guardian Number: 8250745505

Email Address: priyanshubhakta2003@gmail.com

Education Qualification of Parents/Guardian: BSC.PASS

Payment Details: Amount: 200.00 Order ID: 202154822663785

Reference No: VDF4TRMY0200392 Payment Date: 02-07-2021
Communication Address JAIPUR,ROUTHKHANA,ROUTHKHANA,WEST BENGAL,
BANKURA, 722138

Educational Qualification

Name of Exam Board/University/Institute Passing Year Percentage(%) Result

WEST BENGAL BOARD OF SECONDARY

10th 2019 77.14 Qualified
EDUCATION

WEST BENGAL BOARD OF HIGHER

12th(10+2) 2021 Appeared
SECONDARY EDUCATION

Choice of center: Exam from Home PC / Laptop / Tablet / Android Smartphone

Note : Candidates are advised to download and read the CBT Manual provided on website

Preference

SR.No Course Name College Name

1 Bachelor of Optometry (B. OPTOM ) NSHM COLLEGE OF MANAGEMENT & TECHNOLOGY,KOLKATA

2 Bachelor of Optometry (B. OPTOM ) VIDYASAGAR COLLEGE OF OPTOMETRY & VISION SCIENCE

1. Applicant should keep a printout of this application for future reference.

2. This application is provisional.
Candidates should not submit any hardcopy of the application.