Common Nursing Entrance Test (CNET) 2026
[Link]. Nursing (4 Years)
APPLICATION FORM (FINAL PRINT )
Registration Id No. : 126107813
Application Id 58081306 Application Date 29-04-2026 08:35:51
Transaction Id pay_SjiVVGd9YFRw5A Transaction Date 2026-04-30 18:44:51
Bank Reference No/ Order Id order_SjiNyE3yGdAhuh / Paid Amount ₹ 3000
143064704
PERSONAL DETAILS
NAME AYUSH TIWARI FATHER NAME JITENDRA TIWARI
MOTHER NAME LAXMI TIWARI GENDER MALE
AGE ON (December, 31,
DATE OF BIRTH 27/03/2008 18 YEARS, 9 MONTHS & 4 DAYS.
2026)
MOBILE NO. 9455185546 ALTERNATE MOBILE NO. 8853585662
WHATSAPP MOBILE NO. 9455185546 EMAIL TIWARIJEETENDRA679@[Link]
AADHAAR CARD NO. 763698080209 ARE YOU A DOMICILE OF UTTAR-PRADESH? YES
GENERAL (UR -
CATEGORY ECONOMICAL BACKWARD SUB-CATEGORY Not Applicable
CLASSES - EWS)
ADDRESS
PERMANENT ADDRESS
HOUSE NO. / STREET / MOHALLA / AREA / POST
C-373 BARRA -8 BARRA
VILLAGE OFFICE
DISTRICT KANPUR NAGAR STATE UTTAR PRADESH
PINCODE 208027
FULL ADDRESS FOR CORRESPONDENCE
HOUSE NO. / STREET / MOHALLA / AREA / POST
C-373 BARRA -8 BARRA
VILLAGE OFFICE
DISTRICT KANPUR NAGAR STATE UTTAR PRADESH
PINCODE 208027
EXAM CITY PREFERENCE
PREFERENCE 1 : KANPUR PREFERENCE 2 : LUCKNOW PREFERENCE 3 : PRAYAGRAJ
Page 1
Common Nursing Entrance Test (CNET) 2026
[Link]. Nursing (4 Years)
APPLICATION FORM (FINAL PRINT )
Registration Id No. : 126107813
EDUCATIONAL QUALIFICATIONS
EXAMINATION BOARD / INSTITUTE / PASSING MAX. OBTAINED % OF
SUBJECTS
PASSED UNIVERSITY COLLEGE YEAR MARKS MARKS MARKS
PHYSICS,
CHEMISTRY,
HINDI,
DURGAPRASAD
High School CBSE 2024 600 382 63.67 ENGLISH,
VIDYA NIKETAN
MATHS,
INFORMATION
TECHNOLOGY.
MAXIMUM OBTAINED MAXIMUM OBTAINED
SUBJECT SUBJECT
MARKS MARKS MARKS MARKS
Science 100 55 Mathematics / Other 100 58
Social Science 100 61 English 100 60
Hindi / Other Language 100 63
EXAMINATION BOARD / INSTITUTE / PASSING MAX. OBTAINED % OF
SUBJECTS
PASSED UNIVERSITY COLLEGE YEAR MARKS MARKS MARKS
PHYSICS,
CHEMISTRY,
HINDI,
Intermediate DURGAPRASAD
CBSE 2025 - - - ENGLISH,
Appearing VIDYA NIKETAN
BIOLOGY,
PHYSICAL
EDUCATION.
MAXIMUM OBTAINED MAXIMUM OBTAINED
SUBJECT SUBJECT
MARKS MARKS MARKS MARKS
Biology - - Physics - -
Chemistry - - English - -
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Common Nursing Entrance Test (CNET) 2026
[Link]. Nursing (4 Years)
APPLICATION FORM (FINAL PRINT)
Registration Id No. : 126107813
PASSPORT SIZE PHOTO & LIVE PHOTO
VERIFICATION PROFORMA
(Candidate Signature)
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. मैं एतद्द्वारा घोषणा करता / करती हूँ कि इस आवेदन पत्र में दी गई जानकारियां सही है। यदि कोई भी प्रासंगिक जानकारी छिपाई हुई या गलत पाई जाती है, तो मेरी उम्मीदवारी / प्रवेश रद्द किया
जा सकता है।
Page 3