Patliputra University, Patna

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

SESSION 2022 - 2023
UAN # 22T0153674 Reg. Date : 31 August, 2022 01:33 PM

1. Candidate Name : CHHOTI PRIYA

2. Father's Name : ABHAY KUMAR SINGH
3. Mother's Name : SHIVMANI DEVI
4. Date of Birth : 13-Apr-2000 5. Gender : FEMALE
6. Category : General 7. Sub Category : Girls

8. Other Category : Not Applicable 9. AADHAAR : 20*******205

10. Domicile : Jharkhand 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 :

VILL - HISRA BARWADIHPO - GAHAR PATHRAPS - VILL - HISRA BARWADIHPO - GAHAR PATHRAPS -
PATAN PATAN
Palamu Palamu
Jharkhand Jharkhand
PIN Code : 822123 PIN Code : 822123

18. Mobile : 6205367469 19. Email : chotti6200@gmail.com

20. Payment Details: Paid Rs.400.00 on 31/8/2022 Ref# 3104087572627 Bank Ref: NB - IGAOFHTDN2
21. Qualifications PPUP Enrollment (if any) : 192252111107010

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

Highschool Jharkhand Academic Council, Birsadin, Hawai Nagar,... 2016 310330007 500 407
Intermediate Jharkhand Academic Council, Birsadin, Hawai Nagar,... 2018 3101410808 500 274
B.Sc. Zoology 20225110700
Patliputra University, Patna (State University) 2022 1500 904
(Hons) 26
Subjects/Stream : Zoology,Botany,Chemistry

Subjectwise Marks Distribution

Zoology
487/800 = 60.88%
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 [203] B.D. College, Patna M.Sc. Zoology Zoology
4 [201] A.N. College, Patna M.Sc. Zoology Zoology
5 [111] POST GRADUATE DEPARTMENT OF PPU, PA... M.Sc. Zoology Zoology

Printed: Saturday, November 5, 2022 08:56 AM Page: 1/2

 Patliputra University, Patna
Post-Graduate Traditional (PG-T) Admission Application Form
SESSION 2022 - 2023
UAN # 22T0153674 Reg. Date : 31 August, 2022 01:33 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.

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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