Applicant Details

Course Applied Details

Course Name : Bachelor of Engineering

Branch Name 1 :
Branch Name 2 :
Branch Name 3 :

Personal Details:
Candidate's Name: Dipesh Kumar banrait yadav
Father's Name:shree ram kripal yadav
Father's Occupation:farmer
Mother's Name:Gita Devi yadav
Mother's Occupation: house wife
Date of Birth Christian Era (dd/mm/yyy): 18/12/2001
Age:19
Gender: Male / Female (male)
Marital Status: single
Nationality: Nepalese
Are you a Person With disability (PWD): Yes/No
Nepalese Citizenship Details:
Citizenship Number:17-01-75-11242
Citizenship Number Issuing Date:25/12/2018
Citizenship Number Place of Issue:Dhanusha, Nepal

Contact Details
Mobile Number:+9779804324019
Email ID: yadavd1412@gmail.com
Present Address Details
Address Line 1:
Country: Nepal
District: Dhanusha
City: janakpur

Permanent Address Details

Address Line 1:
Country: Nepal
District: Dhanusha
City: dhanushadham

Qualification Details:
Have you passed Class 12th: Yes / No
XIIth or equivalent Details:
Name of the Board Council: CTEVT
Year of Passing for:2077
Total Marks:
Marks obtained:
Percentage:

Subjects Name Maximum Marks Marks Obtained Percentage

Physics

Chemistry

Mathematics

English

Scholarship Details:
Is Any Previous Scholarship received form embassy of India? : Yes / No

Date: Signature: