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Application Form

This document is an application form for 12th based Paramedical/MRT courses submitted by Anjum Paree, a 20-year-old female from Jammu and Kashmir. The application includes personal details, educational qualifications, course preferences, and payment information, confirming successful submission and payment of the application fee. Relevant documents such as domicile and category certificates have been uploaded as part of the application process.

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cha996597
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4 views2 pages

Application Form

This document is an application form for 12th based Paramedical/MRT courses submitted by Anjum Paree, a 20-year-old female from Jammu and Kashmir. The application includes personal details, educational qualifications, course preferences, and payment information, confirming successful submission and payment of the application fee. Relevant documents such as domicile and category certificates have been uploaded as part of the application process.

Uploaded by

cha996597
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Application form for 12th Based Paramedical/MRT Courses

Application No: 112604303565


Application Status: Form submitted.!
Payment Done: Yes
Name: anjum paree Father's Name: abdul khaliq
Mother's Name: shazreen Gender: Female
Date Of Birth(As per 10th class 20 years 10 months 30
02-02-2005 Age as on 01-01-2026
certificate): days
Category: Scheduled Tribe (ST-i) Examination Center: Jammu
Sub Category: CDP Priority:
Issue Date Of Category Next Renewal Date Of
02-07-2016 NA
Certificate: Category Certificate:
Date of issue of Domicile
Resident of UT of J&K ? Yes 08-08-2020
certificate:
Permanent Home Address:
r/o jaran wali gali,po samote,tehsil mendhar Pin Code:185121 District:Poonch UT/State:UT of Jammu and Kashmir
Communication Address:
r/o jaran wali gali,po samote,tehsil mendhar Pin Code:185121 UT/State:UT of Jammu and Kashmir
E-Mail: cha996597@[Link] Mobile:7298091786 Alternate Mobile:
Year College or
Of school from
Exam Passed/Appeared: Exam Status:
passing/ which passed
appearing /appeared
govt hr sec school bhata
Higher Secondary (10 + 2 ) Passed 2022
dhurian
Max Marks Marks Obtained Percentage
500 355 71.00
Marks in 10+2 (Physics): 66 Marks in 10+2 (Chemistry): 78 Marks in 10+2 (Marks): 0 Marks in 10+2 (Bio): 72
Course(S) PREFERENCES:
Para Medical: Yes
MedicalRecordTechnician: Yes
Photograph and Signature
Photograph: Signature: Thumb Impression:

Documents Uploaded
[Link]. Document Name Uploaded
1. Domicile Certificate Yes
2. Marks Secured in Qualifying Examination Yes
3. Reserve Category Certificate Yes
4. Date of Birth Yes
5. Subcategory(if any) No
Payment Receipt
Payment status SUCCESS Payment Gateway Transaction Id CUR32E91G5GCKM
JKBOPEE Transaction ID JKBOPEE2026033113280366487 Payment Date 3/31/2026 1:28:03 PM
Total Application Fee 1000.00 INR Bank Reference No 609013341684
Print
Application form printed on:3/31/2026 1:41:45 PM

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