Patliputra University, Patna

Under-Graduate (UG) Admission Application Form

SESSION 2024
UAN # 24G0079885 Appl. Date : 17 May, 2024 09:59 AM

1. Candidate Name : YASHRAJ KUMAR

2. Father's Name : DHARMENDRA KUMAR
3. Mother's Name : LALITA KUMARI
4. Date of Birth : 23-Jun-2007 5. Gender : MALE
6. Category : BC-I 7. Sub Category : Not Applicable

8. Other Category : Not Applicable 9. AADHAAR : 88*******319

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 :

VILL+POST-ISUA,PS-SARMERA,DIST-NALANDA,PIN VILL+POST-ISUA,PS-SARMERA,DIST-NALANDA,PIN
CODE-811104 CODE-811104
Nalanda Nalanda
Bihar Bihar
PIN Code : 811104 PIN Code : 811104

18. Mobile : 9341098268 19. Email : [email protected]

20. Payment Details: Paid Rs.600.00 on 31/5/2024 Ref# 3494441214230 Bank Ref: UPI - 415262120237
21. Qualifications

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

72455220013
Highschool Bihar School Exam. Board, Sinha Library Road, Patna 2022 500 314
4
86005240101
Intermediate Bihar School Exam. Board, Sinha Library Road, Patna 2024 500 343
96
Subjects/Stream : Science

Subject Obtained Marks Max Marks Percentage %

English 74 100 74.00
Hindi 67 100 67.00
Physics 65 100 65.00
Chemistry 74 100 74.00
Biology 63 100 63.00
Other Qualifications

22. Quota Selection

23. College/Course Chosen (in order of preference)

Pref# College Degree Subject

1 [214] Nalanda College, Biharsharif B.Sc. Zoology (Major) Zoology
2 [210] Kisan College, Nalanda B.Sc. Zoology (Major) Zoology
3 [223] S.P.M College, Nalanda B.Sc. Zoology (Major) Zoology
4 [423] R.L.S.Y. College, Biharsharif, Nalanda B.Sc. Zoology (Major) Zoology
Printed: Friday, July 19, 2024 02:01 PM Page: 1/2
 Patliputra University, Patna
Under-Graduate (UG) Admission Application Form
SESSION 2024
UAN # 24G0079885 Appl. Date : 17 May, 2024 09:59 AM

Pref# College Degree Subject

5 [475] S.P.VERMA COLLEGE RAJAKUAN,BIHARSHR... B.Sc. Zoology (Major) Zoology
6 [416] Nalanda Sodh Sansthan, Biharsharif, Nalanda B.Sc. Zoology (Major) Zoology
7 [214] Nalanda College, Biharsharif B.Sc. Chemistry (Major) Chemistry
8 [210] Kisan College, Nalanda B.Sc. Chemistry (Major) Chemistry
9 [223] S.P.M College, Nalanda B.Sc. Chemistry (Major) Chemistry
10 [418] P.M.S. College, Paharpura B.Sc. Chemistry (Major) Chemistry
11 [475] S.P.VERMA COLLEGE RAJAKUAN,BIHARSHR... B.Sc. Chemistry (Major) Chemistry
12 [423] R.L.S.Y. College, Biharsharif, Nalanda B.Sc. Chemistry (Major) Chemistry
13 [410] K.S.T. College, Sohsarai B.Sc. Chemistry (Major) Chemistry
14 [421] R. LALL COLLEGE ALINAGRA B.Sc. Chemistry (Major) Chemistry
15 [449] Mahatma Budh Hiraman College, Patuana, Bihar... B.Sc. Chemistry (Major) Chemistry
16 [416] Nalanda Sodh Sansthan, Biharsharif, Nalanda B.Sc. Chemistry (Major) Chemistry
17 [421] R. LALL COLLEGE ALINAGRA B.Sc. Zoology (Major) Zoology
18 [410] K.S.T. College, Sohsarai B.Sc. Zoology (Major) Zoology
19 [449] Mahatma Budh Hiraman College, Patuana, Bihar... B.Sc. Zoology (Major) Zoology
20 [425] R.P.S. College, Harnaut B.Sc. Zoology (Major) Zoology

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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