11/1/2019 NEET - PG 2020

Applicant Details

Personal Details
Application Seq No Candidate's Name

PG002264 KAUSTAV JAIN

Father's Name Mother's Name

RISHIKANT JAIN ALKA JAIN

Nationality Gender

INDIAN MALE

Date of Birth Religion

24/Dec/1996 JAINISM

Category Do you Belong to Economically Weaker Section (EWS)

?
GENERAL
NO

Place of Birth Are you a person with disability ?

FARRUKHABAD NO

Are You Willing to Take up Post Graduate Courses in

Armed Forces Medical Services Institutions

NO

Contact Details
Mobile Number Alternate Mobile Number

9818267622 7011628621

Email ID
[email protected]

Identification Details
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Identification Identification No.

AADHAAR CARD 312608398067

Marks of Identification

MOLE ON RIGHT SHOULDER

Correspondence Address
Address Line 1
NEW BOYS HOSTEL

Address Line 2
MAULANA AZAD MEDICAL COLLEGE

Country State

INDIA DELHI

City/District Pin Code

NEW DELHI 110002

Permanent Address
Address Line 1

6/112 VIKAS NAGAR

Address Line 2

BARHPUR

Country State

INDIA UTTAR PRADESH

City/District Pin Code

FARRUKHABAD 209625

Academic Details
State of Completion of Class 10th

MADHYA PRADESH

State of Completion of Class 12th

DELHI

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MBBS Details
Country of completion of MBBS Qualification

INDIA

State
DELHI

City University of Completion

CENTRAL DELHI DELHI UNIVERSITY

Name of College Month and Year of Passing

MAULANA AZAD MEDICAL COLLEGE, NEW D 31/12/2018
ELHI

Internship Details
Have you completed Internship

NO

Location of Internship

NEW DELHI

Institute of Internship Date of start of Internship

MAULANA AZAD MEDICAL COLLEGE 01/01/2019

Likely Date of completion of Internship

31/12/2019

Medical Council Registration Details

MCI/SMC Registration Type
PROVISIONAL

MCI/SMC Registration Number

22991

State of Registration

DELHI

Registration Medical Council

DELHI MEDICAL COUNCIL

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11/1/2019 NEET - PG 2020

MBBS EXAMINATION MARKS

1st MBBS Examination-Percentage of marks obtained
76

2nd MBBS Examination-Percentage of marks obtained

71.81

Final MBBS Examination-Percentage of marks

obtained

66.38

Additional Information
Deported/Rusticated during Medical Course Charged of use of unfair means by NBE/Other
examination body
NO
NO

Have you appeared in NEET PG previously

NO

Test Center Details

State City

DELHI NEW DELHI

Payment Details
Amount Payment Transaction No
3750 RHMP8157597800

Payment Status

Successful

Candidate Images Upload Details

Photo

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11/1/2019 NEET - PG 2020

Signature

Left Thumb Impression

Attachments

To view MCI/SMC registration

certificate of MBBS
QualificationClick here.

Declaration

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11/1/2019 NEET - PG 2020

NEET PG is a proprietary examination and is conducted by National Board of Examinations. The

contents of this exam are confidential, proprietary and are owned by National Board of
Examinations. NBE explicitly prohibits the candidate from publishing, reproducing or transmitting
any or some contents of this exam, in whole or in part, in any form or by any means verbal or
written, electronic or mechanical or for any purpose. No content of this exam must be shared with
friends, acquaintances or third parties including sharing through online means or via social media.
Social media includes but not limited to SMS, Whatsapp, Facebook, Twitter, Hangouts, Blogs etc
using either one’s own account or proxy account(s). By registering for and /or appearing in NEET
PG the candidate explicitly agrees to the above Non Disclosure Agreement and general terms of
use for NEET PG as contained in this information bulletin, and NEET PG website. Violation of any
act or breach of the same shall be liable for penal action and cancellation of the candidature at
the bare threshold.

I certify that I fulfill the eligibility requirements for NEET PG and have furnished complete and
correct information.
I understand that any instances of furnishing incorrect information detected at any stage of the
selection process will automatically disqualify me from the selection process and I will not be
allowed appear for NEET PG in future.
Similarly, if such instances go undetected during the current selection process but, are detected in
subsequent years, such disqualification will take place with retrospective effect.
I also understand that providing incomplete information will automatically disqualify me from the
selection process.
I have read the information bulletin and do hereby undertake that I will not indulge in any unfair
means/practice for NEET PG.
I understand that the decision of NBE shall be final and binding upon me.
Any dispute concerning NEET PG would be subject to Jurisdiction of the Competent Courts
exclusively at Delhi/New Delhi only.
I will comply with the Non Disclosure Agreement as indicated in the information bulletin. I certify
that I have read and gone through the information bulletin for the exam.

Version 13.07.01

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