5/31/24, 9:05 PM Report
ENTRANCE EXAMINATION FOR ADMISSION INTO DIPLOMA IN PHARMACY (D.PHARM) AND
BACHELOR IN PHARMACY (B.PHARM) COURSES IN THE INSTITUTES OF ASSAM FOR THE SESSION 2024
Application Form
Application No. : 245009783
Course : B. PHARM
Name of the Candidate : JAN DEEP KAKATI
Father's Name : BHARAT CHANDRA KAKATI
Mother's Name : ANAMIKA KAKATI
Gender : MALE
Date of Birth : 12/01/2006
Category : OBC/MOBC TGL: NO
Ex - TGL : NO Char Area : NO
Are you Physically Handicapped
NO
(Divyang) :
Physical Identification Marks
Physical Identification Marks 1 :
2:
Are you a Permanent
Nationality : INDIAN
Resident of Assam? : YES
Religion : HINDUISM
Local Address : VILL ALTA
PO DUMUNICHOWKI
PS BAIHATA CHARIALI
City : GUWAHATI Pin : 781121
District : KAMRUP State : 04-ASSAM
Permanent Address : VILL ALTA
PO DUMUNICHOWKI
PS BAIHATA CHARIALI
City : GUWAHATI Pin : 781121
District : KAMRUP State : 04-ASSAM
STD Code :
WhatsApp Mobile No.
Telephone : 6002357185
: 6002357185
Email Address : [email protected]
Centre : GUWAHATI
Subjects you want to appear : English, Physics, Chemistry, Biology
Board : OTHER BOARD
Have you passed Higher Secondary
(10+2) Science or Equivalent
Examination with English, Physics,
Chemistry and Biology and or NO
Mathematics from recongnized
Board/Council/University with grace
marks :
Date of passing HSSLC or
09/05/2024
Equivalent Examination :
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5/31/24, 9:05 PM Report
Name of Educational Institution from
where passed HSSLC or Equivalent RAMANUJAN ACADEMY
Examination :
Name of Board/Council/University
from where passed HSSLC or AHSEC
Equivalent Examination :
MARKS SECURED IN HSSLC OR EQUIVALENT EXAMINATION
Subject Total Marks Mark Secured % marks Obtained
English 100 50 50
Physics 100 60 60
Chemistry 100 71 71
Biology 100 67 67
Mathematics
Aggregate Percentage 63.4
Application Form Submit Date : 29/05/2024 08:35:45
Payment Details
Order ID 113307067079
Fees Paid 1200
Payment Date 29-May-2024
Payment Status Success
Declaration by the Candidate:
I declare that above entries in the Application Form has been filled up by me and the entries made are correct as per my documents and to the best of my knowledge
and belief. I agree that if any statement is proved to be false then the Authority shall have the right to take legal action against me for submitting false information or
statement. I further declare that there is no allegation of misconduct against me and I have never been convicted for any offence involving moral turpitude.
Signature of the Candidate
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