Patliputra University, Patna

Post-Graduate Traditional (PG-T) Admission Application Form

SESSION 2024
UAN # 24T0119558 Reg. Date : 18 June, 2024 02:15 PM

1. Candidate Name : URMILA KUMARI

2. Father's Name : RAJENDRA PRASAD
3. Mother's Name : SHUSHILA DEVI
4. Date of Birth : 16-Dec-1994 5. Gender : FEMALE
6. Category : BC-II 7. Sub Category : Girls

8. Other Category : Not Applicable 9. AADHAAR : 33*******875

10. Domicile : Bihar 11. Dom. Cert. :
12. Religion : Hindu 13. Minority : NO
14. Nationality : INDIAN 15. EWS Status: Not Applicable/No EWS

16. Address for Correspondance : 17. Permanent Address :

W/O VIKASH KUMAR BUDH NAGAR ROAD NO.1 C/O RAJENDRA PRASAD, GRAM-NAWADA , THANA-
CHIRAYATAND,PATNA , BIHAR SIRDALA , NAWADA , BIHAR
Patna Nawada
Bihar Bihar
PIN Code : 800001 PIN Code : 805127

18. Mobile : 9798383625 19. Email : coloursvikash@gmail.com

20. Payment Details: Paid Rs.800.00 on 18/6/2024 Ref# ZIC52081513094 Bank Ref: IC5 - 417050811203
21. Qualifications PPUP Enrollment (if any) :

Examination Board/University Year Roll No. Max. Mrk. Obt. Mrk.

Highschool Bihar School Exam. Board, Sinha Library Road, Patna 2010 8206100760 500 376
Intermediate Bihar School Exam. Board, Sinha Library Road, Patna 2012 0232010122 500 331
B.Sc. Zoology Magadh University, Bodh Gaya.-824 234, Bihar. (State 32831520712
2015 1500 967
(Major) University) 1
Subjects/Stream : Zoology,Botany,Chemistry

Subjectwise Marks Distribution

Zoology
566/800 = 70.75%
Other Qualifications

22. Quota Selection

23. College/Course Chosen (by order of preference) M.Sc. Zoology

Pref# College Degree Subject

1 [225] T.P.S College, Patna M.Sc. Zoology Zoology
2 [205] College of Commerce, Arts and Science, Patna M.Sc. Zoology Zoology
3 [201] A.N. College, Patna M.Sc. Zoology Zoology
4 [207] Ganga Devi Mahila Mahavidalaya, Patna M.Sc. Zoology Zoology
5 [111] POST GRADUATE DEPARTMENT OF PPU, PA... M.Sc. Zoology Zoology

Printed: Wednesday, July 10, 2024 10:42 AM Page: 1/2

 Patliputra University, Patna
Post-Graduate Traditional (PG-T) Admission Application Form
SESSION 2024
UAN # 24T0119558 Reg. Date : 18 June, 2024 02:15 PM

Declaration

I declare that I have never been convicted for any criminal act and that there is no case pending
against me in the court of law. I also declare that I have never been caught using Unfair Means or
any Disciplinary action has been taken against me. If I was charged for using Unfair Means, the
punitive duration is over and charges have been cleared. I have read carefully and have understood
all rules as mentioned in the University Rules and Admission Brochure. Furthermore I also declare
that if my application is found to contain incorrect/false information regarding my Name, Birth Date,
Gender, Religion, Domicile, Weightage, Caste, Horizontal Reservation, Marks obtained or any other
field, my application is liable to get cancelled, and I will have no objection in getting disqualified for
admission to the concerned course/college. I will follow the regulations on curbing the menace of
ragging in higher educational institutions, 2009.

Signature of Parent/Guardian Signature of Candidate

Date: Date:

Document Checklist
NOTE: Mark the number of documents ( Photocopy/Xerox) attached by the Candidate during form submission to the college

Xth Marksheet Xth Certificate

XIIth Marksheet Last Exam Passed Marksheet
Recent Passport Sized Photograph Scanned Signature
Domicile (for other state) Certificate for Kashmiri Resident
Certificate for Category Certificate for Sub-Category
Documents for Claiming Weightage Other Certificate/Document

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