DR.

BHIMRAO AMBEDKAR UNIVERSITY, AGRA

डॉ० भीमराव आं बेडकर िवश्विवद्यालय, आगरा
(FORMERLY AGRA UNIVERSITY, AGRA )
Appl. Date: 28/08/2023

Admission Cum Web Registration Form - 2023-24

WRN No. AU23123031

Name SAMIR

Father's Name ALTAF

Mother's Name FARIDA BANO

Date of Birth 11/FEB/2000

Email Id Samirkhan5800@gmail.com

Gender MALE

Mobile 9541008800

Alter.Mobile 9354557500

Aadhar Card 979206070853

Category OBC

SubCategory NA

Communication SHIV VIHAR COLONY, NEAR B.K SR.SEC.SCHOOL ,PALWAL (121102) STATE:-
Address HARYANA CITY:- PALWAL PINCODE:- 121102

Permanent Address SHIV VIHAR COLONY, NEAR B.K SR.SEC.SCHOOL ,PALWAL (121102) STATE:-
HARYANA CITY:- PALWAL PINCODE:-121102
Qualification Details
S.No. Qualification Board/University Roll No. Total Mark Obt Passing Obtained
Marks Year %

1 10TH CENTRAL BOARD 2124834 100 75 2016 72.5 %

(CGPA)
OF SECONDARY
EDUCATION

2 12TH/DIPLOMA CENTRAL BOARD 2622450 100 72 2019 74 %

(CGPA)
OF SECONDARY
EDUCATION

3 GRADUATION J.C. BOSE 19035301042 100 70 2023 7070 %

(PER)
UNIVERSITY OF
SCIENCE AND
TECHNOLOGY

Payment Details( Paid )

Course CRN. Transaction No. PaymentReferenceNo Amount Date Receipt
MSW AU23518123031 AU231230311 642392808231020893 350/- 08/28/2023 PRINT
10:55:00
Total Weightage 0
 DR. BHIMRAO AMBEDKAR UNIVERSITY, AGRA
डॉ० भीमराव आं बेडकर िवश्विवद्यालय, आगरा
(FORMERLY AGRA UNIVERSITY, AGRA )

Course Code College

MSW 0817 DEPARTMENT OF SOCIAL WORKS,
INSTITUTE OF SOCIAL SCIENCE,
PALIWAL PARK, AGRA

MSW 0275 DEV EDUCATION COLLEGE, BARHAN,

AGRA

Signature of Candidate
Date:-29/08/2023