Personal Details
User ID 8112824
BHAVNA PATNAIK
Candidate's Name
Date of Birth 05/Mar/1997
Country India
Email ID [email protected]
Mobile Number 8018818666
Other Personal Details
Father's/Husband's/Guardian's JATINDRA KUMAR PATNAIK
Name
GITANJALI PATNAIK
Mother Name
Category: General State/Union Territory of Caste/Tribe:
Serial/Entry Number of Caste/Tribe: Gender: Female
Nationality: Indian Other Nationality:
Caste/Tribe Name: Aadhaar Card Number: 933778170253
Do you belong to Persons with Disabilities (PwD) category as per RPwD Act 2016: No
PwD Category:
Do you require wheelchair support at the test centre?: Would you be using a scribe for the Test?:
Communication Address
plot no - 4590 , gadhkan main road near Subhashree Villa
Address Line1
Address Line2 Mancheswar , Bhubaneswar
Address Line3
Country: India Other Country:
State: Odisha Other State:
District: Khordha Other District:
Town/City: Bhubaneswar Pincode: 751017
Emergency Contact Details
Emergency Mobile Number: 7735554191 Relationship with Candidate: Mother
SSC/10th/Equivalent Details
SSC/10th/Equivalent Board Central Board of Secondary Education
Name
Other Board Name
Month/Year of Completion: March 2013 Maximum Marks (Inclusive of all subjects): 500
Total Marks Obtained (Inclusive of all subjects): 380 Aggregate Percentage (%) :76
HSC/12th/Equivalent/Diploma Course Details
Course Type HSC
University/Board/Other
Authority Name
Orissa Council of Higher Secondary Education
HSC Board Name
HSC Other Board Name
Duration of Diploma Course (In Year): HSC Discipline: Science
HSC Other Discipline
Month/Year of Course Commencement: Month/Year of Completion: March 2016
Maximum Marks (Inclusive of all subjects): 600
Total Marks Obtained (Inclusive of all subjects): 320
Aggregate Percentage (%): 53.33
Bachelor's Degree Details
Are you in the final year of Bachelor's Degree?: Yes
Have you completed Bachelor's Degree?: Total Duration of Degree: 3 Year
Current Semester: Semester-5 Aggregate Marks (%): 62.32
Private University
Type of University/Institution
Other Type of
University/Institution
Odisha
State/Union Territory of
University
Others
University/Institute Name
ASBM Institute of Professional Studies
Other University/Institute Name
ASBM Institute of Professional Studies
Name of College/Institution
BBA
Degree Name
Other Degree Name
Management (Business Administration/Business Management/Business Studies/Management
Discipline Studies)
Does the 'Other Discipline' closely relate to 'Engineering/Technology'?:
Other Discipline:
Month/Year of Course Commencement : August 2016
Probable Month/Year OR Month/Year of Completion: April 2019
Second Bachelor's Degree Details
Are you in the final year of Bachelor's Degree?:
Have you completed Bachelor's Degree?: Total Duration of Degree:
Current Semester: Aggregate Marks (%):
Type of University/Institution
Other Type of
University/Institution
State/Union Territory of
University
University/Institute Name
Other University/Institute Name
Name of College/Institution
Degree Name
Other Degree Name
Discipline
Does the 'Other Discipline' closely relate to 'Engineering/Technology'?:
Other Discipline:
Month/Year of Course Commencement:
Probable Month/Year OR Month/Year of Completion:
Master's Degree Details
Do you want to enter Master's Degree details? No
Master's Degree Completion Status: Total Duration of Degree:
Current Semester: Aggregate Marks (%):
Type of University/Institution
Other Type of
University/Institution
State/Union Territory of
University
University/Institute Name
Other University/Institute Name
Name of College/Institution
Degree Name
Other Degree Name
Discipline
Does the 'Other Discipline' closely relate to 'Engineering/Technology'?:
Other Discipline:
Month/Year of Course Commencement:
Probable Month/Year OR Month/Year of Completion
Other Professional Degree Details
Have you completed any professional degree such as CA/CS/ICWA?: No
Degree CA ICWA CS
Degree Completion Status
Name Of Professional Degree
Professional Inter Marks (%): Professional Final Marks (%):
Month/Year of Course Commencement: Month/Year of Completion:
Work Experience
Industry Type Work Experience Industry Type Work Experience
Automobiles/Auto-ancillaries Banking/Financial Services
Durables Engineering/Industrial
Fast Moving Consumer Information Technology
Goods (FMCG)
Pharmaceuticals/Healthcare Retail
Others Telecommunications
Total Work Experience (In months as on July 31 2018):
Programmes
Programme Names Interview City Selected/Not
IIM Ahmedabad PGP Not Selected
IIM Ahmedabad PGP Not Selected
IIM Ahmedabad PGP-FABM Not Selected
IIM Ahmedabad ePGP Not Selected
IIM Ahmedabad ePGP Not Selected
IIM Ahmedabad FPM Not Selected
IIM Amritsar PGP Not Selected
IIM Bangalore PGP Not Selected
IIM Bangalore PGPEM Not Selected
IIM Bangalore PGPPM Not Selected
IIM Bangalore FPM Not Selected
IIM Bodh Gaya PGP Not Selected
IIM Calcutta PGP Not Selected
IIM Calcutta FPM Not Selected
IIM Indore PGP Not Selected
IIM Indore PGP-HRM Not Selected
IIM Indore FPM Not Selected
IIM Jammu PGP Not Selected
IIM Kashipur PGP Not Selected
IIM Kashipur EPGP Not Selected
IIM Kashipur FPM Not Selected
IIM Kashipur EFPM Not Selected
IIM Kozhikode PGP Not Selected
IIM Kozhikode EPGP IIMK Not Selected
IIM Kozhikode EPGP IIMK
Not Selected
Kochi Campus
IIM Kozhikode FPM Not Selected
IIM Lucknow PGP Not Selected
IIM Lucknow PGP-ABM Not Selected
IIM Lucknow PGP-SM Not Selected
IIM Lucknow FPM Not Selected
IIM Nagpur PGP Not Selected
IIM Raipur PGP Not Selected
IIM Raipur FPM Not Selected
IIM Raipur EFPM Not Selected
IIM Ranchi PGP Not Selected
IIM Ranchi PGP-HRM Not Selected
IIM Ranchi PhD Not Selected
IIM Ranchi EPhD Not Selected
IIM Rohtak PGP Not Selected
IIM Rohtak EPGPX Not Selected
IIM Rohtak FPM Not Selected
IIM Rohtak EFPM Not Selected
IIM Sambalpur PGP Hyderabad Selected
RGIIM Shillong PGP Not Selected
RGIIM Shillong PGPEX Not Selected
RGIIM Shillong FPM Not Selected
IIM Sirmaur PGP Not Selected
IIM Tiruchirappalli PGP Not Selected
IIM Tiruchirappalli PGPBM Not Selected
IIM Tiruchirappalli FPM Not Selected
IIM Udaipur PGP Not Selected
IIM Udaipur FPM Not Selected
IIM Visakhapatnam PGP Not Selected
IIM Visakhapatnam FPM Not Selected
Test City Preferences
Preferred Test City 1: Bhubaneswar Preferred Test City 2: Berhampur
Preferred Test City 3: Cuttack Preferred Test City 4: Sambalpur
Payment Details
Payment Mode: online Amount: 1900
Payment Status: S Payment Transaction Number: NHMP6644296750
Order ID: 811282420180904094818272
Declaration
I hereby certify that the information given by me in this Application Form is true to the best my knowledge. I certify that I fulfill the CAT
2018 eligibility criteria and undertake to produce original documents whenever necessary and I will not demand any reschedule of
exam. I agree to abide by the declaration of the authorities regarding the eligibility of my application and understand that any
misrepresentation or omission of facts in my application may justify cancellation of my CAT 2018 application and scores. I understand
that all disputes will be subject to the territorial jurisdiction of city of Kolkata only.
