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Document From Habibullah

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17 views

Document From Habibullah

Habib

Uploaded by

Habib channel champaran
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Application No.

: 90820496 ALIGARH MUSLIM UNIVERSITY


Session : 2024-25 GENERAL
Application Form for admission to
PRE-TIB
NATIONAL COMMISSION FOR INDIAN
SYSTEM OF MEDICINE

Receivable No.: 1309610, Date: 22-06-2024 14:09:13, Amount: 100.00 Nationality: India , Domicile State:
Preference for Test Centres:
1. Aligarh (U.P.) 2. Patna (Bihar)
Personal Details:
Name: HABIBULLAH Date of Birth: 19 March, 2003
Father's Name: ASGHAR ALAM Gender: MALE
Mother's Name: RAUSHAN ARA BEGAM Religion: Islam
Phone 1: 7088561845 Phone 2: 7005780055 Email: [email protected]
Details of Qualifying Examination: Status & Special Categories:
Examination: MOULVI (XII) Status: EXTERNAL
Roll No.: 02028 Enrolment No.:
Year of Passing/Appearing: 2021 Hall:
Board/Univ.: Bihar State Madrasa Education Special Categories:
Board, Patna EW, (120000, N.A.)
Percentage: 58.33%
Remark (if any).:
Is hostel accommodation required? YES#
Name of the Examination Board/University Year Roll No. % of Marks
MOULVI (XII) Bihar State Madrasa Education Board, Patna 2021 02028 58.33
MOULVI (XII) Bihar State Madrasa Education Board, Patna 2021 02028 58.33
Address for Correspondence Permanent Address
WARD 06, VILL MATHIA, IN FRONT OF MATHIA WARD 06, VILL MATHIA, NEAR MATHIA MASJID
MASJID PO BAHLOLPUR, PS KALYANPUR, EAST
PO BAHLOLPUR, PS KALYANPUR, EAST CHAMPARAN
CHAMPARAN Bihar, 845413, India
Bihar, 845413, India

DECLARATION: I SOLEMNLY UNDERTAKE to accept and abide by the rules of the Aligarh Muslim University and all the decisions of the Academic Council & other
appropriate University bodies in regard to my admission. I hereby solemnly affirm that I have gone through the Guide to Admissions & Supplements applicable for this
course and solemnly declare on oath that the entries made by me in the above columns are true to the best of my knowledge and belief and if at any time, the entries are
found incorrect, the admission may outrightly be cancelled and disciplinary action may be initiated against me.
# Hostel accommodation is not guaranteed; it is subject to availability of seats in the hostel

Application No. 90820496/PTCUA

For office use (Procotor's Office) For office use (DSW's Office)

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