STATE MEDICAL FACULTY OF WEST BENGAL

ENTRANCE EXAMINATION - 2020

(SMFWBEE-2020)
ONLINE APPLICATION FORM

Registration No:102279

Candidate's Name: SAYANTAN SARKAR

Father's Name: SIBAPRASAD SARKAR

Mother's Name: ANIMA SARKAR

Gender: MALE

Category: SC

Religion: HINDU

Date of Birth: 05-04-2000

Physically Handicapped: NO

Domicile State: WEST BENGAL Home District: Paschim (West) Burdw

Nationality: INDIAN Aadhaar No: 847941032184

Email Address: sayantansarkardgp@gmail.com Mobile Number: 9064061496

Mode of CBT: Exam from Home PC/ Laptop/ Mobile(Android)

Correspondence Address:
VILL-GOPALPUR UTTAR PARA SANNYASHITALA, PO-GOPALPUR, PS-KANKSA, DURGAPUR-12, WEST BENGAL, BARDHAMAN, 713212

Educational Qualification

Name of Exam Board/University/Institute Passing Year Roll No Result Status

WEST BENGAL COUNCIL OF HIGHER SECONDARY

12th Standard EDUCATION 2017 2003111379 Qualified

Subject Theory (Full Theory (Passing Theory (Secured Theory Practical (Full Practical (Passing Practical (Secured Practical
Name Marks) Marks) Marks) Result Marks) Marks) Marks) Result

PHYSICS 70 21 34 Passed 30 9 26 Passed

CHEMIST
RY 70 21 26 Passed 30 9 26 Passed

BIOLOGY 70 21 35 Passed 30 9 29 Passed

Payment Details: Amount: 500.00, Payment Transaction Id: EVZHBWKO0102279 , Payment Date: 13-09-2020

Note: 1. Read the CBT instruction manual carefully.

2. You must take the mock test compulsorily.

3. This application is Provisional and shall be considered Valid only once the fee is reconciled with the bank.

4. Visit website www.smfwb.in regularly for updated information.

Date: 27-11-2020