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MV Mandalis
MV Mandalis
MV Mandalis
Serial:
Only
Course Applied for : B.M.S.(with Credits) - Regular - Rev16 - F.Y. B.M.S. Sem I (22300005) PRN:
Application Date : 03/09/2021 Payment Category :
1.Personal Information
Candidate's Name(Regional) : अभिषेक
ABHISHEK PRASAD
Candidate's Name as printed on
[*This name will appear on all University
Mark sheet :
records/documents]
Father's/Husband's Name : RAVINDRA PRASAD Mother's Name : NEELAM
Marital Status : UnMarried Mother Tongue : Hindi
Place Of Birth : Mumbai Gender : Male Date of Birth (DD/MM/YYYY) : 23/01/2004
Blood Group : BPositive Religion : Hindu Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
City/Town/Village :
State : Maharashtra District : Mumbai City Tehsil : Mumbai Location Area : Rural
Mumbai
Address (House
no,street/area/suburb 316 Juhu, Ruia Park,Jr Mahatre Rd Moragaon Pin Code : 400049
etc.) :
Permanent Address :
City/Town/Village :
State : Maharashtra District : Mumbai City Tehsil : Mumbai Location Area : Rural
Mumbai
Address : 316 Juhu, Ruia Park,Jr Mahatre Rd Moragaon Pin Code : 400049
Contact details
Mobile
9004788306 Email ID: abhishek23012004@gmail.com
Number
2.Legal Reservation Information
Category Type :
Category : GEN
Open
Is Specially Abled? No
3.Social Information(Additional Inforamtion)
Leaving Certificate.
DECLARATION
I hereby declare that all the information furnished by me in this application form is true, complete and correct to the best of my
knowledge and belief. I do understand that I need to obtain and produce all the required documents. I Application No :2547357
(ABHISHEK PRASAD) admit to having understood what constitutes ragging and sexual harassment. I have read the guidelines
related to the same. I hereby affirm that if found guilty of ragging or sexual harassment I am liable for punishment according to
the university regulations.
Place : Date :
( Signature of the Candidate )
For College/Institute/Study Center Use Only
Designation Signature and
Remarks / Particulars / Recommendations
Date
Admission Clerk
Admission
Committee
Accountant/Cashier Cash Received: INR Receipt No.: Date:
Registrar/Office
Superintendent
Document printed on Thu Sep 09 2021 10:12:20 GMT+0530 (India Standard Time)