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ADDRESS DETAILS
Current Address Sasanda, Jajpur 755027, Jajapur, Odisha, 755027, India
Permanent Address Sasanda, Jajpur 755027, Jajapur, Odisha, 755027, India
FAMILY DETAILS
No of members in the family 3 Annual Family Income(in Rs.) 41,000.00
No. of children studying in family 1 Are you child of a single parent? No
Are both your parent’s deceased? No
FAMILY MEMBERS
Relationship Name Education Occupation
Father Subash Chandra Agnihotry 12th Grade Farmer
SECONDARY EDUCATION
Medium
Passing Max Obtained
Education Board Institute Name Of State City %
Year Marks Marks
Instruction
12th 78
Rc Nodal High
10th 2020 Orissa Board Oriya Odisha Jajapur 600.00 467.00 77.83
School
GRADUATION
Institute Duration Passing Max Obtained
Education Degree Type Degree Program Name/Uni State City (Years) Year Marks Marks
versity
Biju Patnaik
Institute Of
Information
B.Pharm.(Bachelor
UG Pharmacy Technology Odisha Rourkela 4 2026
of Pharmacy) &
Management
Studies
DOCUMENTS
Document Document Name
Photo ID Proof Course fees 2.pdf
Current Address Proof aadhaar.pdf
Applicant photo PhotoStudio_1666453462519.jpeg
Family income proof income .pdf
Marksheet of 10th Class Board Examination matric certificate .pdf
Marksheet of 12th Class Board Examination 12th mark.pdf
Proof of enrollment in current institution Course fees 2.pdf
Note to Applicant: If you are arrested for, charged with, or convicted of an offence, or any proceedings are instituted or pending
against you, or any warrant or summons issued for your arrest or appearance, or if there is any change in your status or
representations in relation to misconduct after the submission of this application, you must PROMPTLY (within 30 days of the
arrest, charge, misconduct report, etc.) inform the Reliance Foundation Scholarships team at
rf.ugscholarships@reliancefoundation.org