1552309087545_confirmation Letter_gupta Ritik Rakesh.pdf

NATIONAL ELIGIBILITY CUM ENTRANCE TEST (UG) CONFIRMATION PAGE - NEET(UG)-2019 You have successfully submitted On-line Application. Please preserve this pagealong withproof of fee payment for future reference.

Application No. : 190411065117

Candidate's Name Mother's Name Father's Name Year of Passing/Appearing Class XII State/Country to which Applicant belongs Question Paper Medium Mobile No.

GUPTA RITIK RAKESH SAVITA RAKESH 2019

Date of Birth Gender Category Person with Disability:

08/06/2001 Male UR No

Maharashtra

Nationality

Indian

English 91xxxxxx5219

Class XII Marks(%) Email Id

[email protected] m

Choice of Exam Cities MUMBAI ( 3110) NAVI MUMBAI ( 3114)

THANE ( 3118)

NASHIK ( 3113)

DECLARATION :- I hereby solemnly and sincerely affirm that all the particulars stated by me in the Application Form are true and correct. Even the spelling of names and category are also correct. I have not concealed any information including information about previous attempts in AIPMT/NEET. However, if any information furnished herein is found fraudulent, incorrect or untrue, I understand that I will be liable for criminal prosecution which will result incancellation of my candidature. Further that the selection and admission to the course is liable to be cancelled. I agree to abide by the Rules and Regulations governing the Examination as contained in the Information Bulletin for NEET, 2019 which I have gone through carefully. I further declare that I have not submitted any other application for NEET, 2019 and mobile no and email address given in the form are correct and my own or of my parents.

Photo

Signature

Complete Mailing Address Address 402,SHREERAM COMPLEX,NEW KANERI ROAD,BEHHIND KAMLA HOTEL,BHIWANDI, BHIWANDI, OPP.KAMLA HOTEL City BHIWANDI ,THANE State/Country Maharashtra Pin Code 421308 Details of Transaction(ICICI Bank) Transaction ID.: 651174779 Total Amount: 1400 Card Type: VISA/Master Card

Date of Transaction: 11/23/2018 5:57:03 PM

Application No:

Printed On : 23/11/2018 05:57:59

190411065117

Note : - Kindly check following details in Confirmation Page : Candidate’s Name, Mother’s Name, Father’ s Name, Date of Birth, Gender, Category, PwD, Choice of Examination Cities and Medium of Question Paper. In case of any discrepancy, these may please be corrected during 14th January, 2019 to 31st January, 2019. No corrections shall be allowed under any circumstances after this date.