GOKULA EDUCATION FOUNDATION (MEDICAL)

M.S. Ramaiah Medical College

MSR College Road, MSR Nagar, MSRIT Post, Mathikere, Bengaluru, Karnataka 560054

2022 - 23
Form No.- MBBS-85

Personal Information
Full Name ASMI BHARDWAJ
DOB Dec 20,2004 Gender FEMALE
Email Id asmibhardwaj20@gmail.co Mother's Name SAUMYA SHARMA
m
State of Domicile KARNATAKA Applicant Registered 7625085960
Mobile Number
Alternate Contact No 9535626290 Religion HINDU
Caste BRAHMIN Sub Caste
Mother Tongue HINDI Admission Quota Type: NRI
Reserve Category: NRI Sub-Category -
Program Type Regular Blood group B+
Adhaar Card Number 403239580572
Nationality Indian
Marital Status Single
Residence Address Details
Residence Address P-5/3 VISHWA VIHAR
CV RAMAN NAGAR, VURTHUR ROAD, OFF OLD MADRAS ROAD
BANGALORE-93
Country INDIA State KARNATAKA
City Pin 560093
BENGALURU
Taluka District BANGALORE URBAN
-
Permanent Address Details
Permanent Address D-703, PALAM APARTMENTS, SECTOR-5, PLOT-7, DWARKA, NEW DELHI
Country INDIA State DELHI
City Pin 110075
DELHI
Taluka District DWARKA
-
Candidate Seeking NRI No
Admission
Parent Details
Father's Full Name: Amit Kumar Sharma
Mother's Full Name: Saumya Sharma
Father's Email ID : amibharadwaj@gmail.com Father's Mobile No. : 9535626290
Mother's Email ID : saumyamittalsharma@gmail.com Mother's Mobile No. : 9880128960
Address : P 5/3 Vishwa Vihar, Vurthur Road, Bangalore Bangalore East 560093
Pin Code : 560093
Father's Profession : Service Mother's Profession : home Maker
Father's Qualification : PG MTech Mother's Qualification : PG
Father's office Phone : 9535626290 Mother's office Phone :
Father's office Address : ASTE, Wind Tunnel road, Vimanpura
Mother's office Address : NA
Annual Income : 2000000 Pan Card number : ANIPS7218M
Guardian Details
Guardian Full Name Amit Kumar Sharma
Email ID : amibharadwaj@gmail.com Mobile No. : 9535626290
Address : P 5/3 Vishwa Vihar, Vurthur Road, Age : 44
Bangalore
Pin Code : 560093 Relation : Father
Entrance Details
1. Entrance Exam NEET ENTRANCE EXAM 2022
Application Id 220410442871 Roll No. 2712080142
Score 270 Total Score 720

MSR COLLEGE ROAD, MSR NAGAR, MSRIT POST, MATHIKERE, BENGALURU, KARNATAKA 560054 Page 1
 GOKULA EDUCATION FOUNDATION (MEDICAL)

M.S. Ramaiah Medical College

MSR College Road, MSR Nagar, MSRIT Post, Mathikere, Bengaluru, Karnataka 560054

Rank 377868
Percentile 79
Documents attached
1 ORIGINAL - UGET-KEA-2022 SEAT ALLOTMENT ORDER
2 NEET UGET-2022 - SCORE/RANK CARD
3 Marks card of qualifying examination (10 & 12th Standard)
4 Transfer Certificate from the Institution Last attended (School/College)
5 Migration Certificate from the (Board /University last Attended)
6 Character / Conduct Certificate from Institution last attended
7 4 (Four) Passport size colour photos
8 Bond submitted to KEA-CET with regards to Rural Services (For local Govt. Quota)
9 In case of NRI sponsored candidates enclose (Sponsorship letter from the Sponsor and Copy of Passport/Resident Visa of Sponsor)
10 ID PROOF
Physically Handicapped/ Sports/ Defence Or ExServiceman:
Physically Handicapped : No Sports school Defence Or Ex- Not Applicable
(Basket Ball) Serviceman
Declaration to be signed by the Applicant:
DECLARATION BY THE APPLICANT

I Asmi Bhardwaj declare that i have known the financial obligations and i can afford to pay the cost and undertake to pay the tuition and other
fees payable to the institute under the rules framed from time from the management of the college.

Place :

Date : Dec 11, 2022 05:29 PM

Signature of Candidate

MSR COLLEGE ROAD, MSR NAGAR, MSRIT POST, MATHIKERE, BENGALURU, KARNATAKA 560054 Page 2