DEPARTMENT OF MEDICAL EDUCATION AND RESEARCH, GOVERNMENT OF HARYANA
NEET-UG-2024
ONLINE APPLICATION FORM FOR ADMISSION TO MBBS/BDS COURSES 2024-25
Registration No. 249039 Version No. : 1
Candidate's Name PRIYANSHI MAURYA
Father's / Husband's Name RAJESH MAURYA
Mother's Name SEEMA MAURYA
Gender Female
DOB 19/08/2004
Correspondence Address KG-1/123, VIKASPURI , NEW DELHI, VIKASPURI, NEW DELHI, New Delhi (Delhi (DL)) - 110018
Permanent Address KG-1/123, VIKASPURI , NEW DELHI, VIKASPURI, NEW DELHI, New Delhi - Delhi (DL) - 110018
Are You Resident / Domicile of Haryana ? No
NEET Roll Number 2001890446 NEET Application Number 240410166568
NEET Score 464 NEET Percentile 88.8253403
All India Rank 259850 All India Category Rank 19430
:: Aadhar Card Number ********6082
:: Category Details
Applied Category SC
Converted Category SC
:: Horizontal Reservation
Are you a Candidate with Bench Mark Desabilities (PwBD) No
Are you Ward of Armed Personnel of Haryana No
Are you dependent of Freedom Fighter of Haryana No
Do you belong to Muslim Minority No
:: NRI Details
Are you eligible for NRI Quota Seats No
NRI Category N.A.
Passport Number
Account Number 0249102000018009
Account Holder Name PRIYANSHI MAURYA
Bank Name (Branch Name) IDBI Bank (J-1, VIKASPURI, VIRJANAND MARG, NEW DELHI-110018)
IFSC Code IBKL0000249
:: Qualification Details
Maximum Marks / Obtained Marks / Grade
Education/Qualification School Name State Name Board Name Percentage Year of Passing
Grade
CENTRAL BOARD OF
10th ADARSH PUBLIC SCHOOL Delhi (DL) SECONDARY EDUCATION 500.000 432.000 86.400 2020
12th ADARSH PUBLIC SCHOOL Delhi (DL) CENTRAL BOARD OF
SECONDARY EDUCATION 500.000
452.000 90.400 2022
:: Required Documents
Sr. No. Document Name
1 Matriculation/High School Certificate (10th)
2 10+2/Intermediate/Senior Secondary School Examination Certificate/Detailed Marks Sheet
3 Character Certificate issued by the School/Institute last attended.
4 NEET Score Card
5 Copy of Aadhar Card
6 Copy of Cancelled Cheque / Passbook Page Showing Account Details (For Post Matric Scholarship / Refunds (If Applicable))
:: Paid Fee Details
Reference No. Fee Amount Transaction Date Order Id
241010198755335 2500.00 10-10-2024 09:34:59 575068
Reference No. Security Fee Amount Transaction Date Order Id
241010198755606 100000.00 10-10-2024 09:37:42 575069
::Options Given By You
Sr. No. Institute Name & Address Government/Govt. Aided/Private Medical/Dental Colleges & Category Course Preference No.
of seats
1 SGT Dental College, (SGT University) Gurugram Private Dental College B.D.S. 1
Declaration
I solemnly affirm and declare:-
That I have filled In the Application form myself and the Information given there in Is absolutely correct and true. I understand that if Information is found to be incorrect at any stage, my
candidature for admission to the course shall stand cancelled. I undertake that if admitted I will strictly obey all rules and regulations for admission to UG Courses in force at present or which may be
modified here after and will do nothing either inside the College/Institute or outside it, that may interfere with its orderly administration and discipline. At any stage of admission process, if it is
discovered that any information given in this application or in the attached certificates or in the documents produced here after is incorrect/false, I may be removed and my candidature shall stand
cancelled from the college/institute and all fee paid by me my be forfeited. The authorities may also take any further legal action against me as if may deem fit. I have checked the minimum eligibility
criteria, for admissions to UG courses as mentioned in the Information bulletin for NEET-UG-2024 & therefore abide by the cut off score in the respective category.
Printed On : 2024-10-16 09:19:48 PM Signature of Candidate
Application Last Modified On : 2024-10-10 10:24:47 AM (PRIYANSHI MAURYA)
