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UNIVERSITY OF RAJASTHAN

URATPG-2022 PAHSE II APPLICATION FORM

DEPARTMENT OF PHYSICS

M.SC. : PHYSICS

FORM NO : 2202112175

Name of the Candidate : ANKIT YADAV

Father’s Name : BRIJ MOHAN YADAV

Mother’s Name : MANJU YADAV

DOB : 03/MAY/2003

Gender : MALE Weightage Concession Category SPORTS

Caste Category : OBC Aadhar No: 389954013986

Special Category : NO Victims of Jaipur Bomb Blast : NO

Mobile No. : 8619466382 Email ID : ANKITYADAVJPR351@GMAIL.COM

Permanent
Address Correspondence
Address:

FARM-RAWATAWALI , VILLAGE- FARM-RAWATAWALI , VILLAGE-

Address : Address 1:
AMARPURA AMARPURA

City: Post-Nathawala, Shahpura,jaipur Address 2: Post-Nathawala, Shahpura,jaipur

District : SHAHPURA State : RAJASTHAN

State : RAJASTHAN CITY : SHAHPURA

PIN : 303103 PIN : 303103

Score Card -
Sr No TEST SUBJECT TEST SCORE SCORE FOR ADMISSION (70%)
1 24 : Physics 41 28.700

Programme Preference-
Sr No. Programme Name Subject TEST SCORE SCORE FOR ADMISSION (70%)
1 175:M.Sc. : Physics 24:Physics 41 28.700

EDUCATIONAL QUALIFICATION
Name of Examination Name of Board/Univiersity Year Max Marks/Grade Obt Marks/Grade %/CGPA Result
10TH CBSE 2017 A1 A1 10 CG DECLARED
12TH CBSE 2019 500 333 66.6% DECLARED
B.SC. UNIVERSITY OF RAJASTHAN 2022 1350 950 70% DECLARED

Signature of Candidate
 UNIVERSITY OF RAJASTHAN

URATPG-2022 PAHSE II APPLICATION FORM

DEPARTMENT OF PHYSICS

M.SC. : PHYSICS

Summary Report Cum Payment Receipt/Challan

FORM NO:
2202112175

TEST ROLL NO: 240153

Name of Applicant
Date of Birth
Permanent Address

Special
Mother's Name
Department Name Gender
Mobile Number

Category
Father's Name Category Phone Number
ANKIT YADAV

03/MAY/2003 FARM-RAWATAWALI , VILLAGE-AMARPURA Post-Nathawala,

MANJU YADAV
DEPARTMENT OF
MALE
NO
Shahpura,jaipur

BRIJ MOHAN PHYSICS

OBC 8619466382
YADAV

Form No. Amount Transaction ID Transaction Date

2202112175 200 220901129541811 01/09/2022 7:27:14 PM
Attach following along with Application Form:

1. Secondary / Senior Secondary School Marksheet

2. Undergraduate Marksheet.

3. Candidates belonging to S.C., S.T. OBC, MBC, EWS category will be required to
produce a certificate to that effect from a District Magistrate/Tehsildar/Sub-
Divisional
Magistrate, without which their cases will not be considered under the
provision O.81-II, and as per directions of the State Government. Validity of
Certificates will be as
per rules of the Government of Rajasthan. For Most
Backward Classes, Economically Weaker Sections will be as per the Government of
Rajasthan.

    * Original Challan of Application Fee For Each Programme.

    * The Caste Certificate of OBC/MBC/EWS should not be more than one year old. The validity of OBC/MBC Certificate can be extended for a period of 3 years from
issue date on submitting an affidavit of Non-Creamy Layer by the Applicant on 50 Rs Non- judicial stamp paper.

4. PH Certificate (if applicable).

5. Certificate Document to Claim Weightage (Sports / NSS / NCC any other ) if any.

Submit Hard Copy of Application Form to:

DEPARTMENT OF PHYSICS

University of Rajasthan,

Jaipur
Declaration by the Applicant

I ANKIT YADAV, S/o BRIJ MOHAN YADAV solemnly affirm and declare on oath that-

1. All the information given in the form are correct to the best of my knowledge and belief.

2. I undertake to remain in the University as a dicisplined student and abide by the orders issued from time to time by authorities of the
University/College/Department.

3. I have not been found guilty of any unfair practice in the Board/University Examination.
4. In the event of any change in Statutes/Ordinances/Rules/Regulations/Syllabi and Books made by amending or remaking, I shall, except in sc far as
the University determines otherwise, compIy with the Change(s) that apply to the years of study which I have not completed at the time of the
change.

5. I am not joining two courses simultaneously.

6. If I happen to accept any remunerative job during the courses of my study, I will inform the Department/College/Institute/Centre immediately.

7. I have not been convicted of any criminal offence nor have I been released on bail in connection with a criminal case.

8. No case of criminal offence or moral turpitude is pending against me in any court of Law.

9. No complaint or F.I.R. has been lodged against me by the University/Principal of Constituent College/HOD/Affiliated College or by any other
competent authority.

10. I have not resorted to an act of indiscipline during the previous year.

11. I was not notified as being an unauthorised occupant of any accomodation in any University Hostel by the Chief Warden/Warden concerned in the
immediately preceding Year.

12. If I do not satisfy the eligibility rules of admission and if any information given by me is found to be false, my admission shall stand cancelled.

13. If I do not complete the attendance as per the requirements of the University, I shall not be allowed to appear as a regular candidate in University
Examination.

14. If I damage University/College property in addition to the disciplinary action taken, I or my parents/guardian shall have to compensate for the
damages incurred.

15. If I am found involved in incidents of ragging, I agree to abide by the decision of the University authorities or their representatives in the matter as
per the directives of the Hon'ble Supreme Court regulatory institutions.

Signature of Candidate
 STUDENT COPTY

UNIVERSITY OF RAJASTHAN

STUDENT GROUP INSURANCE FORM

SESSION 2022-23

DEPARTMENT OF PHYSICS

COURSE :
M.SC. : PHYSICS

Name of Student Father's Name Date of Birth Class Phone/Mobile No

BRIJ MOHAN YADAV 03/MAY/2003 8619466382

Mother's Name Parmanent Address

ANKIT YADAV
FARM-RAWATAWALI , VILLAGE-AMARPURA

MANJU YADAV POST-NATHAWALA, SHAHPURA,JAIPUR

RAJASTHAN
 
SHAHPURA
 
303103

Nominee's Name Relation Local Address

Signature of Nominee Signature of Student

DEPARTMENT COPY

UNIVERSITY OF RAJASTHAN

STUDENT GROUP INSURANCE FORM

SESSION 2022-23

DEPARTMENT OF PHYSICS

COURSE :
M.SC. : PHYSICS

Name of Student Father's Name Date of Birth Class Phone/Mobile No

BRIJ MOHAN YADAV 03/MAY/2003 8619466382

Mother's Name Parmanent Address

ANKIT YADAV
FARM-RAWATAWALI , VILLAGE-AMARPURA

MANJU YADAV POST-NATHAWALA, SHAHPURA,JAIPUR

RAJASTHAN
 
SHAHPURA
 
303103

Nominee's Name Relation Local Address

Signature of Nominee
Signature of Student
 UNIVERSITY OF RAJASTHAN

Application Form (Phase-II)

URATPG-2022
Anti Raging Form Session 2022-23

DEPARTMENT OF PHYSICS

M.SC. : PHYSICS

FORM NO:
2202112175

TEST ROLL NO:240153

में ANKIT YADAV पुत्र/पुत्री श्री BRIJ MOHAN YADAV , जाती OBC निवासी FARM-RAWATAWALI , VILLAGE-AMARPURA POST-
NATHAWALA, SHAHPURA,JAIPURSHAHPURA RAJASTHAN शपथ पूर्वक निम्नलिखित कथन करता/करती हूँ -

1. यह कि मैंने राजस्थान विश्वविद्यालय के DEPARTMENT OF PHYSICS विभाग / कॉलेज / सेंटर में कक्षा M.SC. : PHYSICS सत्र में प्रवेश लेने हेतु आवेदन
किया है ।

2. यह कि विश्वविद्यालय विभाग / कॉलेज / सेंटर द्वारा प्रवेश दिए जाने पर मै रैगिंग से सम्बंधित किसी भी प्रकार की गतिविधि मै प्रत्यक्ष या अप्रत्यक्ष रूप से समिलित
नहीं होऊं गा /होउंगी एवं ऐसी किसी भी गतिविधि में सहयोग नहीं करूँ गा / करुँ गी ।

3. यह कि अध्ययन के दौरान में रैगिंग से सम्बंधित किसी गतिविधि में प्रत्यक्ष या अप्रत्यक्ष रूप से लिप्त पाया / पायी जाऊ तो विश्वविद्यालय / विभाग / सेंटर को मेरे
विरुद्ध अनुशासनात्मक कार्यवाही करने का अधिकार होगा जिसमे विश्वविद्यालय
/ विभाग / सेंटर से निष्कासन एवं विश्वविद्यालय की परीक्षा से वंचित करना भी हो
सकता है । विश्वविद्यालय को मेरी अंकतालिका / प्रमाण-पत्र में रैंगिंग कि गतिविधि के बारे में रिमार्क अंकित करने का भी अधिकार होगा जिसके विरुद्ध में कोई आपत्ति
या उज्र नहीं करूँ गा / करुँ गी ।

हस्ताक्षर शपथ ग्रहिता

सत्यापन

में ANKIT YADAV उपरोक्त शपथ पत्र ग्रहिता शपथ पत्र के मद संख्या 01 से 03 को अपनी स्वयं की जानकारी एवं विश्वास से सही होना तस्दीक करता / करती हूँ।
इसमें कोई तथ्य छिपाया नहीं गया है , ईश्वर मेरा साक्षी है ।

हस्ताक्षर शपथ ग्रहिता

 UNIVERSITY OF RAJASTHAN

URATPG-2022 PAHSE II APPLICATION FORM

CENTRE FOR COMPUTER SCIENCE & INFORMATION TECHNOLOGY

M.SC. : IT (SFS)

FORM NO : 2202112178

Name of the Candidate : ANKIT YADAV

Father’s Name : BRIJ MOHAN YADAV

Mother’s Name : MANJU YADAV

DOB : 03/MAY/2003

Gender : MALE Weightage Concession Category SPORTS

Caste Category : OBC Aadhar No: 389954013986

Special Category : NO Victims of Jaipur Bomb Blast : NO

Mobile No. : 8619466382 Email ID : ANKITYADAVJPR351@GMAIL.COM

Permanent
Address Correspondence
Address:

FARM-RAWATAWALI , VILLAGE- FARM-RAWATAWALI , VILLAGE-

Address : Address 1:
AMARPURA AMARPURA

City: Post-Nathawala, Shahpura,jaipur Address 2: Post-Nathawala, Shahpura,jaipur

District : SHAHPURA State : RAJASTHAN

State : RAJASTHAN CITY : SHAHPURA

PIN : 303103 PIN : 303103

Score Card -
Sr No TEST SUBJECT TEST SCORE SCORE FOR ADMISSION (70%)
1 24 : Physics 41 28.700

Programme Preference-
Sr No. Programme Name Subject TEST SCORE SCORE FOR ADMISSION (70%)
1 178:M.Sc. : IT (SFS) 24:Physics 41 28.700

EDUCATIONAL QUALIFICATION
Name of Examination Name of Board/Univiersity Year Max Marks/Grade Obt Marks/Grade %/CGPA Result
10TH CBSE 2017 A1 A1 10 CG DECLARED
12TH CBSE 2019 500 333 66.6% DECLARED
B.SC. UNIVERSITY OF RAJASTHAN 2022 1350 950 70% DECLARED

Signature of Candidate
 UNIVERSITY OF RAJASTHAN

URATPG-2022 PAHSE II APPLICATION FORM

CENTRE FOR COMPUTER SCIENCE & INFORMATION TECHNOLOGY

M.SC. : IT (SFS)

Summary Report Cum Payment Receipt/Challan

FORM NO:
2202112178

TEST ROLL NO: 240153

Name of
Date of Birth
Permanent Address

Applicant
Special
Department Name Gender
Mobile Number

Mother's Name
Category
Category Phone Number
Father's Name
ANKIT YADAV

03/MAY/2003 FARM-RAWATAWALI , VILLAGE-AMARPURA Post-

MANJU YADAV CENTRE FOR COMPUTER SCIENCE &
MALE
NO
Nathawala, Shahpura,jaipur

BRIJ MOHAN INFORMATION TECHNOLOGY

OBC 8619466382
YADAV

Form No. Amount Transaction ID Transaction Date

2202112178 200 220901129541811 01/09/2022 7:27:14 PM
Attach following along with Application Form:

1. Secondary / Senior Secondary School Marksheet

2. Undergraduate Marksheet.

3. Candidates belonging to S.C., S.T. OBC, MBC, EWS category will be required to
produce a certificate to that effect from a District Magistrate/Tehsildar/Sub-
Divisional
Magistrate, without which their cases will not be considered under the
provision O.81-II, and as per directions of the State Government. Validity of
Certificates will be as
per rules of the Government of Rajasthan. For Most
Backward Classes, Economically Weaker Sections will be as per the Government of
Rajasthan.

    * Original Challan of Application Fee For Each Programme.

    * The Caste Certificate of OBC/MBC/EWS should not be more than one year old. The validity of OBC/MBC Certificate can be extended for a period of 3 years from
issue date on submitting an affidavit of Non-Creamy Layer by the Applicant on 50 Rs Non- judicial stamp paper.

4. PH Certificate (if applicable).

5. Certificate Document to Claim Weightage (Sports / NSS / NCC any other ) if any.

Submit Hard Copy of Application Form to:

CENTRE FOR COMPUTER SCIENCE & INFORMATION TECHNOLOGY

University of Rajasthan,

Jaipur
Declaration by the Applicant

I ANKIT YADAV, S/o BRIJ MOHAN YADAV solemnly affirm and declare on oath that-

1. All the information given in the form are correct to the best of my knowledge and belief.

2. I undertake to remain in the University as a dicisplined student and abide by the orders issued from time to time by authorities of the
University/College/Department.

3. I have not been found guilty of any unfair practice in the Board/University Examination.
4. In the event of any change in Statutes/Ordinances/Rules/Regulations/Syllabi and Books made by amending or remaking, I shall, except in sc far as
the University determines otherwise, compIy with the Change(s) that apply to the years of study which I have not completed at the time of the
change.

5. I am not joining two courses simultaneously.

6. If I happen to accept any remunerative job during the courses of my study, I will inform the Department/College/Institute/Centre immediately.

7. I have not been convicted of any criminal offence nor have I been released on bail in connection with a criminal case.

8. No case of criminal offence or moral turpitude is pending against me in any court of Law.

9. No complaint or F.I.R. has been lodged against me by the University/Principal of Constituent College/HOD/Affiliated College or by any other
competent authority.

10. I have not resorted to an act of indiscipline during the previous year.

11. I was not notified as being an unauthorised occupant of any accomodation in any University Hostel by the Chief Warden/Warden concerned in the
immediately preceding Year.

12. If I do not satisfy the eligibility rules of admission and if any information given by me is found to be false, my admission shall stand cancelled.

13. If I do not complete the attendance as per the requirements of the University, I shall not be allowed to appear as a regular candidate in University
Examination.

14. If I damage University/College property in addition to the disciplinary action taken, I or my parents/guardian shall have to compensate for the
damages incurred.

15. If I am found involved in incidents of ragging, I agree to abide by the decision of the University authorities or their representatives in the matter as
per the directives of the Hon'ble Supreme Court regulatory institutions.

Signature of Candidate
 STUDENT COPTY

UNIVERSITY OF RAJASTHAN

STUDENT GROUP INSURANCE FORM

SESSION 2022-23

CENTRE FOR COMPUTER SCIENCE & INFORMATION TECHNOLOGY

COURSE :
M.SC. : IT (SFS)

Name of Student Father's Name Date of Birth Class Phone/Mobile No

BRIJ MOHAN YADAV 03/MAY/2003 8619466382

Mother's Name Parmanent Address

ANKIT YADAV
FARM-RAWATAWALI , VILLAGE-AMARPURA

MANJU YADAV POST-NATHAWALA, SHAHPURA,JAIPUR

RAJASTHAN
 
SHAHPURA
 
303103

Nominee's Name Relation Local Address

Signature of Nominee Signature of Student

DEPARTMENT COPY

UNIVERSITY OF RAJASTHAN

STUDENT GROUP INSURANCE FORM

SESSION 2022-23

CENTRE FOR COMPUTER SCIENCE & INFORMATION TECHNOLOGY

COURSE :
M.SC. : IT (SFS)

Name of Student Father's Name Date of Birth Class Phone/Mobile No

BRIJ MOHAN YADAV 03/MAY/2003 8619466382

Mother's Name Parmanent Address

ANKIT YADAV
FARM-RAWATAWALI , VILLAGE-AMARPURA

MANJU YADAV POST-NATHAWALA, SHAHPURA,JAIPUR

RAJASTHAN
 
SHAHPURA
 
303103

Nominee's Name Relation Local Address

Signature of Nominee
Signature of Student
 UNIVERSITY OF RAJASTHAN

Application Form (Phase-II)

URATPG-2022
Anti Raging Form Session 2022-23

CENTRE FOR COMPUTER SCIENCE & INFORMATION TECHNOLOGY

M.SC. : IT (SFS)

FORM NO:
2202112178

TEST ROLL NO:240153

में ANKIT YADAV पुत्र/पुत्री श्री BRIJ MOHAN YADAV , जाती OBC निवासी FARM-RAWATAWALI , VILLAGE-AMARPURA POST-
NATHAWALA, SHAHPURA,JAIPURSHAHPURA RAJASTHAN शपथ पूर्वक निम्नलिखित कथन करता/करती हूँ -

1. यह कि मैंने राजस्थान विश्वविद्यालय के CENTRE FOR COMPUTER SCIENCE & INFORMATION TECHNOLOGY विभाग / कॉलेज / सेंटर में कक्षा
M.SC. : IT (SFS) सत्र में प्रवेश लेने हेतु आवेदन किया है ।

2. यह कि विश्वविद्यालय विभाग / कॉलेज / सेंटर द्वारा प्रवेश दिए जाने पर मै रैगिंग से सम्बंधित किसी भी प्रकार की गतिविधि मै प्रत्यक्ष या अप्रत्यक्ष रूप से समिलित
नहीं होऊं गा /होउंगी एवं ऐसी किसी भी गतिविधि में सहयोग नहीं करूँ गा / करुँ गी ।

3. यह कि अध्ययन के दौरान में रैगिंग से सम्बंधित किसी गतिविधि में प्रत्यक्ष या अप्रत्यक्ष रूप से लिप्त पाया / पायी जाऊ तो विश्वविद्यालय / विभाग / सेंटर को मेरे
विरुद्ध अनुशासनात्मक कार्यवाही करने का अधिकार होगा जिसमे विश्वविद्यालय
/ विभाग / सेंटर से निष्कासन एवं विश्वविद्यालय की परीक्षा से वंचित करना भी हो
सकता है । विश्वविद्यालय को मेरी अंकतालिका / प्रमाण-पत्र में रैंगिंग कि गतिविधि के बारे में रिमार्क अंकित करने का भी अधिकार होगा जिसके विरुद्ध में कोई आपत्ति
या उज्र नहीं करूँ गा / करुँ गी ।

हस्ताक्षर शपथ ग्रहिता

सत्यापन

में ANKIT YADAV उपरोक्त शपथ पत्र ग्रहिता शपथ पत्र के मद संख्या 01 से 03 को अपनी स्वयं की जानकारी एवं विश्वास से सही होना तस्दीक करता / करती हूँ।
इसमें कोई तथ्य छिपाया नहीं गया है , ईश्वर मेरा साक्षी है ।

हस्ताक्षर शपथ ग्रहिता