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  • AIPMT - 2015 - Confirmation Page For Application Number - 6016033

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    हिमाँशु पाल
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    uruyrtytrytrtyr

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    AIPMT- 2015_ Confirmation Page for Application Number _6016033

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    42 vues1 page

    AIPMT - 2015 - Confirmation Page For Application Number - 6016033

    Transféré par

    हिमाँशु पाल
    uruyrtytrytrtyr

    Droits d'auteur :

    © All Rights Reserved
    Téléchargez comme PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    sur 1

    12/23/2014

    AIPMT2015:ConfirmationPageforApplicationNumber:6016033

    CENTRALBOARDOFSECONDARYEDUCATION
    ClickHeretoPrintThisPage

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    CONFIRMATIONPAGEAIPMT2015
    Application/RegistrationNo.

    6016033

    YouhavesuccessfullysubmittedApplicationOnline.Kindlytaketheprintoutofthispage.PleasepreservethisformalongwithoriginalEChallan(iffeepaid
    byEChallan)forfuturereference.
    Candidate'sName

    VARSHAPAL

    DateofBirth

    13/10/1997

    Mother'sName

    SANDHYAPAL

    Gender

    Female

    Father'sName

    RAJENDRAPAL

    Category

    OBC

    YearofPassing/AppearingClassXII 2015

    PersonwithDisability

    No

    State/CountrytowhichApplicant
    belongs

    Haryana

    Nationality

    Indian

    QuestionPaperMedium

    English

    ClassXIIMarks(%)

    MobileNo.

    919034672218

    EmailId

    himpal16@gmail.com

    ChoiceofExamCentres

    (1)DELHI(508)

    (2)CHANDIGARH(505)

    (3)JALANDHAR(540)

    (1)1stState:Haryana/(OBC)

    (2)2ndState:NA

    (3)3rdState:NA

    (4)ALLIndia:Yes/(OBC)

    (5)ParticipatingUNIV./INST.:Yes

    OptionForSeats/EligibleCategory

    DECLARATION:IherebysolemnlyandsincerelyaffirmthatalltheparticularsstatedbymeinthisApplicationFormaretrueandcorrect.Ihavenot
    concealedanyinformation.However,ifanyinformationfurnishedhereinisfoundfraudulent ,incorrectoruntrue,IunderstandthatIwillbeliableto
    criminalprosecutionandIalsoagreetoforegomyseat.Furtherthattheselectionandadmissiontothecourseisliabletobecancelled.Iagreetoabide
    bytheRulesandRegulationsgoverningtheExaminationascontainedintheAIPMT2015InformationBulletinavailableonwebsite,whichIhaveduly
    gonethrough.IfurtherdeclarethatIhavenotsubmittedanyotherapplicationforAIPMT2015andmobilenoandemailaddressarecorrectandare
    givenintheformofmyownorofmyparents.

    Signature

    LeftHandThumbImpression

    Photo
    Completemailingaddress:
    Address

    C54SHIVDURGAVIHAR,PHASEII,LAKKARPUR

    City

    FARIDABAD

    State/Country

    Haryana

    PinCode

    121009

    DetailsofTransaction(SyndicateBank).
    TransactionID.:BSMP3602922249

    Amount(ServiceTaxExtra):1200

    DateofTransaction12/23/201412:03:20
    PM

    CardType:VISA/MasterCard

    RegistrationNo:

    6016033

    http://aipmt.nic.in/aipmt/online/ConfirmationPage.aspx

    PrintedOn:23/12/2014

    1/1

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