Mponline Form

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Personal Details Photo


Signature
Applicant's ROSHAN SAXENA / रोशन
Profile Id 1062231242149
Name सक्सेना
SANJAY
Father's Name Mother's Name SWEETY SAXENA
SAXENA
Date of Birth (dd/mm/yyyy)
(As per class 10th mark sheet or birth 30/06/1998 Gender पुरूष (M)
certificate)
Domicile State Madhya Pradesh Category अनारक्षित (UR)

Handicapped Details
Are you a handicapped (Minimum 40 percent) नहीं(No) If yes, type of disability
If the applicant is locomotor disabled, its type -
Marital Status
Are you married? नहीं(No) Spouse Name
Date of marriage if the applicant is married (dd/mm/yyyy) -- जीवित बच्चो की संख्या
Date of Birth of Last Child (dd/mm/yyyy) -- क्या अंतिम बच्चे जुड़वा हैं? नहीं(No)
Contact Details
Present Address
Address Mansarovar 129, Aakriti Aquacity, 11 mile, bypass road Bhopal
State MADHYA PRADESH District BHOPAL Pin Code 462047
Permanent Address
Address Mansarovar 129, Aakriti Aquacity, 11 mile, bypass road Bhopal
State MADHYA PRADESH District BHOPAL Pin Code 462047
Mobile No XXXXXX3391 Email XXXXXXXXXXXXXXX@gmail.com
Qualification Details
Passed University
Course Pass Course Obtained Total Percent
Qualification Exam Subject / Board Roll No.
Type Year System Marks/Points Marks/Points %
Name Name
10th (High
Science- Full
HSC School 2014 CBSE 1178393 CGPA 08.4 10 79.80
Maths Time
Certificate)
11th / 12th
(Higher
Science- Full
HSSC Secondary 2016 CBSE 1675600 MARKS 297 500 59.40
Maths Time
School
Certificate)
BE -
Civil Full
UG Bachelor of 2020 RGPV 0103CE161090 CGPA 7.89 10 78.90
Engineering Time
Engineering
Download Domicile Certificate

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