Common Nursing Entrance Test (CNET) 2026
[Link]. Nursing (4 Years)
APPLICATION FORM (FINAL PRINT )
Registration Id No. : 126052054
Application Id 58037649 Application Date 12-04-2026 02:33:52
Transaction Id pay_ScWfmRWS9Exim2 Transaction Date 2026-04-12 14:37:20
Bank Reference No/ Order Id order_ScWd40ZrqLMzgQ / Paid Amount ₹ 3000
143024041
PERSONAL DETAILS
NAME SALONI CHAUHAN FATHER NAME SUDARSHAN CHAUHAN
MOTHER NAME KAVITA DEVI GENDER FEMALE
18 YEARS, 9 MONTHS & 3
DATE OF BIRTH 28/03/2008 AGE ON (December, 31, 2026)
DAYS.
MOBILE NO. 8467089704 ALTERNATE MOBILE NO. 6307145074
WHATSAPP MOBILE NO. 8467089704 EMAIL SR3706180@[Link]
AADHAAR CARD NO. 255661828589 ARE YOU A DOMICILE OF UTTAR-PRADESH? YES
OBC (OTHER BACKWARD
CATEGORY SUB-CATEGORY Not Applicable
CLASSES)
ADDRESS
PERMANENT ADDRESS
HOUSE NO. / STREET / MOHALLA / AREA / POST
VILLAGE CHAKMEUVAN POST SIRSAL
VILLAGE OFFICE
DISTRICT AZAMGARH STATE UTTAR PRADESH
PINCODE 276207
FULL ADDRESS FOR CORRESPONDENCE
HOUSE NO. / STREET / MOHALLA / AREA / POST
VILLAGE CHAKMEUVAN POST SIRSAL
VILLAGE OFFICE
DISTRICT AZAMGARH STATE UTTAR PRADESH
PINCODE 276207
EXAM CITY PREFERENCE
PREFERENCE 1 : AZAMGARH PREFERENCE 2 : VARANASI PREFERENCE 3 : LUCKNOW
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Common Nursing Entrance Test (CNET) 2026
[Link]. Nursing (4 Years)
APPLICATION FORM (FINAL PRINT )
Registration Id No. : 126052054
EDUCATIONAL QUALIFICATIONS
EXAMINATION BOARD / INSTITUTE / PASSING MAX. OBTAINED % OF
SUBJECTS
PASSED UNIVERSITY COLLEGE YEAR MARKS MARKS MARKS
HINDI
ENGLISH
INDRASANI I C
MATHEMATICS
BARAHATIR
High School UP BOARD 2023 600 517 86.17 SCIENCE
JAHANAGANJ
SOCIAL
AZAMGARH
SCIENCE
DRAWING
MAXIMUM MAXIMUM
SUBJECT OBTAINED MARKS SUBJECT OBTAINED MARKS
MARKS MARKS
Science 100 85 Mathematics / Other 100 91
Social Science 100 87 English 100 77
Hindi / Other Language 100 93
EXAMINATION BOARD / INSTITUTE / PASSING MAX. OBTAINED % OF
SUBJECTS
PASSED UNIVERSITY COLLEGE YEAR MARKS MARKS MARKS
HINDI
SWAMI DAYANAND ENGLISH
Intermediate UP BOARD S I C SURAI 2025 500 394 78.80 PHYSICS
AZAMGARH CHEMISTRY
BIOLOGY
MAXIMUM MAXIMUM
SUBJECT OBTAINED MARKS SUBJECT OBTAINED MARKS
MARKS MARKS
Biology 100 82 Physics 100 81
Chemistry 100 81 English 100 75
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Common Nursing Entrance Test (CNET) 2026
[Link]. Nursing (4 Years)
APPLICATION FORM (FINAL PRINT)
Registration Id No. : 126052054
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