COMPLETE APPLICATION FORM : JEE B.Ed.

-2017

Registration No.511207781

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A-Personal Detail
Name of Candidate MUSHARRAF ALI KHAN
Gender MALE Married NO
Nationality INDIAN Religion MUSLIM
Father's Name MUAZZAM ALI KHAN
Date of Birth 16/06/1992 Paper-II(Group) Science
Category General(GEN) Sub-Category Not Applicable
Mother's Name KITABUN NISHA KHAN
Parent's Annual Income 48000 Domicile of UP U.P.
Examination city option 1. Lucknow 2. Kanpur 3. Gorakhpur

B-Qualifying Exam Detail

Class University/College Year Marks Total Marks Percentage
Graduation LU 2014 1091 1800 61
Post Graduation NA NA NA NA NA
Graduation with Sanskrit NO Paper-I General Knowledge, ENGLISH
Weightage Type N/A Weightage 0

C-Details of Application Fee

Transaction No. : OL4722822301425512253 Amount: 1000 Date: 2017-04-10 15:33:47

Payment Mode: (BOB)BOB BANK

D-Mailing Address:
Name: MUSHARRAF ALI KHAN

Address: SS 2 473
SECTOR F
JANKIPURAM

District: LUCKNOW

State: UTTAR PRADESH

PinCode: 226021

Email ID: MUSHRULES@GMAIL.COM

Mobile No. 9454319943

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Signature or Thumb Impression of

Left Thumb Impression of Candidate Signature of the Candidate
Parent / Guardian

5f808a52a70eab21544f829c7d9dfc9b4/13/2017 3:43:06 PM
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