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APPLICATION FORM :

PERSONAL INFORMATION

APPLICATION NO. : 209034

FULL NAME: RAJESH KUMAR NANDI

DATE OF BIRTH: 03-03-2003

MOBILE NUMBER: 7873518048

ALTERNATE MOBILE NUMBER: 7894303072

EMAIL ID: RAJESHPIKUN26@GMAIL.COM

COURSE APPLIED FOR: INTEGRATED PHD

JEST DISCIPLINE: PHYSICS

GENDER: MALE

RESERVATION CATEGORY: OTHER BACKWARD CLASS

FEES AMOUNT: 800.00

EXAM CITY: EXAM CITY PREFERENCE 1 BHUBANESWAR

EXAM CITY PREFERENCE 2 SAMBALPUR
EXAM CITY PREFERENCE 3 KOLKATA

PERSON WITH DISABILITY (PWD) NO

CURRENT ADDRESS: ADDRESS: DUNDAKOT, BASTA, BALASORE

STATE/U.T.: ODISHA (OD)
CITY: BALASORE
PINCODE: 756081

PERMANENT ADDRESS: ADDRESS: DUNDAKOT, BASTA, BALASORE

STATE/U.T.: ODISHA (OD)
CITY: BALASORE
PINCODE: 756081

EDUCATION DETAILS
 EXAMINATION NAME OF PASSING BOARD/UNIVERSITY/ CGPA/GRADE MAXIMUM MARKS PERCENTAGE
THE YEAR INSTITUTE MARKS OBTAINED
SCHOOL/
COLLEGE/
INSTITUTION

*10TH / DUNDAKOT 2018 BOARD OF 600 497 82.83

MATRIC / HIGH SECONDARY
EQUIVALENT SCHOOL, EDUCATION, ODISHA
DUNDAKOT

*12TH / SAI H S 2020 COUNCIL OF HIGHER 600 488 81.33

INTERMEDIATE/ SCHOOL, SECONDARY
EQUIVALENT TAKATPUR EDUCATION, ODISHA

*GRADUATION DEB RAY APPEARING UNIVERSITY

BSC (DEGREE)
COLLEGE,
MAJOR NAYAPALLI
SUBJECT:
PHYSICS

UPLOADED DOCUMENTS:

PAYMENT

BANK REFERENCE
STATUS FEE DETAILS NO. TRANSACTION DATE PAYMENT MODE

SUCCESSFUL 800 JEST2024-OL126172 22-01-2024 ONLINE

DECLARATION:

I CONFIRM THAT THE INFORMATION GIVEN IN THIS FORM IS TRUE, COMPLETE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE AND BELIEF AND IN CASE OF ANY OF THE ABOVE INFORMATION IS FOUND TO BE FALSE OR UNTRUE OR
MISLEADING OR MISREPRESENTING, IT MAY LEAD TO THE CANCELLATION OF MY CANDIDATURE AND ORGANIZING
INSTITUTE CAN TAKE LEGAL ACTION AGAINST ME.

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