MJBC-5070026284

Mahatma Jyothiba Phule BC Welfare Residential Educational Institutions

Society, BACKLOG CET
Admission Test for 8th Class (2023-24)

Personal Details
1 Reference Id : 5070026284
2 Surname : POLAMANI
3 Candidate Name : POLAMANI AKSHITHA
4 Father's Name : KRISHNA
5 Mother's Name : POLAMANI LINGAMMA
6 Date of birth : 17/5/2010
7 Gender : Female
8 Address : 2-83
INMULNARVA
KOTHUR
Mandal : KOTHUR
District : RANGAREDDY(SHAMSHABAD)
Pincode: 509228
9 e-Mail : -
10 Mobile : 6300955099
11 Alternate Mobile : -
12 Reservation Category : BC-D
13 SubCaste : Mudiraj, Mutrasi, Tenugollu
14 Are you an Orphan : Yes
15 Whether the Annual Income of Parent is Yes
below Rs.1,50,000(rural) or 2,00,000(urban) :
Examination Center Details
16 Medium in which candidate desires to appear ENGLISH
for the Test:
17 Examination Center/District at which RANGAREDDY(SHAMSHABAD)
Candidate desires to appear for the Test :
18. Education Details
S. No Year Of Study Class in which Medium of study District in which Select whether the
Studied/Studying school of study is School is
located (Govt./Govt Aided/
Govt Recognized)
1. 2021-2022 6th ENGLISH RANGAREDDY(SH Govt
AMSHABAD)
2. 2022-2023 7th ENGLISH RANGAREDDY(SH Govt
AMSHABAD)
19.Payment Details
Fee Amount Journal Number Payment Date
100 /- YSBI1812267530 29/03/2023
I hereby declare that
I read the information bulletin of Admission Test for 8th (2023-24) and found myself fully eligible to appear for
the entrance test as per the criteria mentioned in the Information Bulletin.
The information furnished above is true and to the best of my knowledge. I will produce the original as and when
asked by the Department at the time of Admission. I am aware that any wrong information furnished by me disqualifies
my selection automatically.
Sd/-
POLAMANI AKSHITHA

29/03/2023 01:41:58 PM
5070026284