Uttar Pradesh GNM Entrance Test (UP GET) 2025

GNM Nursing Course (3 Years)

APPLICATION FORM (FINAL PRINT)
Registration Id No. : 625023203

Application Id 78016794 Application Date 28-04-2025 04:52:05

Transaction Id pay_QOSkKVXPxb8wPQ Transaction Date 2025-04-28 17:04:27
Bank Reference No. order_QOSjOZCRAQcGM1 Paid Amount 2000

Personal Details
Name MADHU Father/Husband Name RAJENDRA PRASAD
Mother Name MEENA DEVI Gender FEMALE
Date of Birth 29/04/2003 Age on (December, 31, 2025) 22 YEARS, 8 MONTHS & 2 DAYS.
Mobile No. 8052391065 Alternate Mobile No. 8052139230
WhatsApp Mobile No. 8052391065 Email AMITKANOJIYA940@[Link]
Aadhaar Card No. 981147689305 Are you a Domicile of Uttar-Pradesh? YES
Category SC (SCHEDULED CASTE) Sub-Category NA

Address
Permanent Address
House No./ Street / Village PAUNI JAPTI Mohalla / Area / Post Office GAUR
District BASTI City BASTI
State UTTAR PRADESH Pincode 272163
Full Address for Correspondence
House No./ Street / Village PAUNI JAPTI Mohalla / Area / Post Office GAUR
District BASTI City BASTI
State UTTAR PRADESH Pincode 272163

Academic Qualifications
Passing Max. Obtained
Examination Passed Board / University Institute / College Year Marks Marks % of Marks Subjects
High School UP BOARD CHANDRABHAN SINGH 2018 600 405 67.50 HINDI, ENGLISH,
INTER COLLEGE MATHEMATICS,
ITBAHARA BASTI SOCIAL SCIENCE,
SCIENCE,DRAWING
Examination Maximum Obtained Percentage Examination Subjects Maximum Obtained Percentage
Subjects Marks marks Marks marks
ENGLISH 100 68 68.00 HINDI / OTHER 100 73 73.00
LANGUAGE

Intermediate UP BOARD CHANDRABHAN SINGH 2020 500 338 67.60 GENERAL HINDI,
INTER COLLEGE ENGLISH,
ITBAHARA BASTI PHYSICS,
CHEMISTRY,
BIOLOGY
Examination Subjects Maximum Marks Obtained marks Percentage Examination Subjects Maximum Marks Obtained marks Percentage
Core Subjects
PHYSICS 100 63 63.00 CHEMISTRY 100 58 58.00
BIOLOGY 100 82 82.00 ENGLISH 100 60 60.00

Are you an ANM candidate? NO

Exam City Preference

Preference 1 : BASTI Preference 2 : LUCKNOW Preference 3 : AYODHYA
Bank Account Details for Refund
Account No. as per Bank 75128993701 Name as per Bank Record MADHU IFSC Code as per Bank BARB0BUPGBX
Record : : Record :
Name of Bank : BARODA U P State : UTTAR District : BASTI
BANK PRADESH
 Uttar Pradesh GNM Entrance Test (UP GET) 2025
GNM Nursing Course (3 Years) APPLICATION FORM (FINAL PRINT)
Registration Id No. : 625023203

PASSPORT SIZE PHOTO & LIVE PHOTO

VERIFICATION SHEET

PASSBOOK FRONT / CANCELLED CHEQUE PHOTO

DECLARATION
I hereby declare that the particulars given in this application form are correct. if any relevant information is found to be concealed or incorrect
my candidature/ admission may be cancelled.

(Candidate Signature)