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Common Application Form

Common PG Entrance Test, Academic Session (2024-25)


Higher Education Department, Government of Odisha 24P0030290
Friday, May 24, 2024 9:49:25 AM

Personal Details
Applicant's Name : BIKRAM KUMAR BHOL
Father's Name : KALU CHARAN BHOL
Mother's Name : MAMATA BHOL
Blood Group : B+ Gender : MALE
Religion : HINDU Date of Birth : 09-Dec-2002
Identification Type : AADHAAR Identification No : ********2222

State of Domicile : APAAR ID : NOT


ODISHA
PROVIDED

Address for Correspondence


Details(Plot/Flat/Building/Village) : PLOT NO -221, GHATIKIA Block / ULB : BHUBANESWAR (MC)
District : KHURDA State : ODISHA
PIN Code : 751029 Mobile No. : 6371135228
Whatsapp No. : 6371135228 Alternative Mobile No. : NA

E-RES/2024/00303
e-Mail : [email protected] Residence Certificate Barcode :
(Not Verified)

REVENUE OFFICERS
NOT BELOW THE RANK
Issuing Authority : OF TAHASILDAR / Issuing Date : NOT PROVIDED
ADDITIONAL
TAHASILDAR

Reservation Details
Social Category : GENERAL PWD : NO
Sub Category : NONE Applicant's welfare Classification : NA

Weightage Details
NCC : NA NSS : NA
Rover & Ranger : NA Sports & Games : NA

Graduation Examination :PASSED

Educational Qualification

+2 Equivalent/Stream : SCIENCE

Name Of The Examination Stream / Mark Board / University Year Of Roll No. Max Secured %
Class Type Passing Marks / Marks / Secured
CGPA CGPA

GRADUATION/EQUIVALENT COMMERCE CGPA UTKAL UNIVERSITY 2023 2003010190100027 10 6.54 60.40

Note: If you have entered incorrect details (not having at least 24 credits but mentioned the same), your candidature will be cancelled during admission and
document verification process.

Graduation Subject
Passed Graduation With ? : HONOURS
Core/Hons/Major : COMMERCE Credit : 84
1st Sem Generic Elective : COMMERCE Credit : 6
2nd Sem Generic Elective : COMMERCE Credit : 6
3rd Sem Generic Elective : COMMERCE Credit : 6
4th Sem Generic Elective : COMMERCE Credit : 6

Subject For PG Entrance Examination

SL# Subject

1 COMMERCE

Preference Of Examination Zone


BHUBANESWAR

Payment Details

Payment Date Payment Amount Transaction Number Payment Mode Payment Through

24-May-2024 500.00 414562583876 UPI SBIEPAY

Bank Account Details


Account Number : 50100697841206 IFSC Code : HDFC0003722
MICR Code : NA Bank Name : HDFC BANK
Branch Name : KHANDAGIRI

Income details
Mother's
Father's Occupation : GOVT.SERVICE OTHERS
Occupation :
Annual Income of the
2.5 to 8.0 lakh Actual Income : 500000.00
parents(together) in Rs. :
To Whom the
Income Certificate Barcode : NOT PROVIDED Certificate is NOT PROVIDED
Issued :

Issuing Authority : NOT PROVIDED Issuing Date : NOT PROVIDED

Other Information
Special Category (For GSSY Scholarship) : None of these
Does your parents qualify as beneficiaries for KALIA Yojana? : No
Does your parents hold a Labour card? : No

* You are Provisionally Eligible for following Scholarship Scheme.

Scholarship Scheme

SL# Scholarship Name

1 e-Medhabruti - PG Merit
2 NUA-O Scholarship

Declaration

I BIKRAM KUMAR BHOL ,solemnly affirm that the information furnished above is true and correct in all respect to the best of my knowledge and
belief. I have not concealed any information. I undertake that if any information herein is found to be incorrect or false, I shall be liable for action as
per rules in force.

Date:
Place: Signature of Applicant

5/24/2024 9:49:26 AM

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