Student Information

Application Number: APPLN-116691 FFE ID: FFEUID080969

Name: Boomika C Birthdate: Fri Mar 14, 2003
Email: boomikac6780@gmail.com Mobile: 8762745812
Gender: Female Phone: 8762745812
Aadhar No: 861870944535
Address: Anjana Medical; Bigbazar; Near Pillai
Hotel,
Munirabad Project Area,Karnataka,
583233,India

Facilitator's Information

Facilitator Name: FFE ID:

Address:

Family Information

Father's Name: Raghavendra Mother's Name: Jyothi

Father's Education: GRADUATION Mother's Education: SSLC
Father's Age: 46 Mother's Age: 43
Father's Occupation: Small Business Mother's Occupation: Homemaker
Parent's Mobile: 9448006780 Parent's Phone: 9036006780
Annual Family Income: 50000.00

Previous Academic Details

10th - Board Type: SSC 12th - Board Type: SSC

10th - Year Passed: 2018 12th - Year Passed: 2020
10th Marks Obtained: 580.0 12th Marks Obtained: 550.0
10th Maximum Marks: 625 12th Maximum Marks: 600
10th Medium Of Instruction: English 12th Medium Of Instruction: English
10th %: 92.80 12th %: 91.67
10th Type: Private 12th Type: Private

Page 1 of 4 Foundation For Excellence India Trust, # 840, MHT House, 1st Floor, 5th Main, Indiranagar 1st Stage, Bangalore 560 038
 Entrance Test Information

Entrance Test Name: National

Entrance Exam Taken In Year: 2022
Eligibility Cum Entrance Test
Entrance Test Marks: Entrance Exam Maximum Marks:
Entrance Test Rank: 13876

Course/College Particulars

College Name: Karnataka Institute of

College City: Hubli
Medical Sciences
College State: Karnataka Course: MBBS
Branch/Stream: Course Year: Year I, Sem 1

Bank Information

Account Name: C Bhoomika IFSC code: CNRB0011241

Bank Account No: 110093326118 Bank State: Karnataka
Bank Name: Canara Bank Bank Pincode: 583233
Bank City: Hubli Bank Branch Phone No:
Branch Address: Canara Bank,branch
Hubballi Kmc Vidyanagar, Kims, Hubli

Other Information

Receiving Full AICTE/Fee Waiver Scholarship/Financial Asst Other

from Gvt: No Than FFE?: No

Fee details

College Fees: 64040 Hostel/Mess Expenses: 37200

Books Expenses: 0 Transportation Expenses: 0
Uniform Expenses: 0 Total Amount: 101240.00

Page 2 of 4 Foundation For Excellence India Trust, # 840, MHT House, 1st Floor, 5th Main, Indiranagar 1st Stage, Bangalore 560 038
 About Yourself and Your Family

What is your ambition in life?

 Doctor

Who has inspired you the most until now?

 My brother Because he is serving society

Tell us some thing about yourself?

 Playing badminton

Describe your family's income?

 We belong to middle class family

When you start earning,how you'd help?

 Serving society

Page 3 of 4 Foundation For Excellence India Trust, # 840, MHT House, 1st Floor, 5th Main, Indiranagar 1st Stage, Bangalore 560 038
 Facilitator's Remarks

Student Name : Boomika C

Student Id : FFEUID080969

Have you been able to visit the student's house.?

Have you met the student's parent(s).?

Has the student provided satisfactory justification on the amounts asked by him/her for the college fees,
hostel mess charges, transport charges, books stationery and uniform.?

Are you convinced about the genuineness of the critical financial need of the student's family and that the
student truly deserves a scholarship from FFE.?

Please comment on parent's education, occupation, family background and gross family income and
wealth/assets, if any.

Facilitator's Declaration

I ..................................... have verified all the documents and proofs submitted by the student.

Date : ___________ Facilitator Signature : __________________

Page 4 of 4 Foundation For Excellence India Trust, # 840, MHT House, 1st Floor, 5th Main, Indiranagar 1st Stage, Bangalore 560 038