Submit Date : 12/11/2024
Application No:
GOVERNMENT OF GUJARAT 242500000000026410
BCK-79 Food Bill Assistance For Medical,Engineering Students
(SEBC)
Renewal Application
Previous Application No: 232400000001166245
Previous Paid Scholarship:
Student Personal Details
Name of Student : PATEL HELI MUKESHKUMAR
Name of Student (As per Aadhar) : HELI MUKESHKUMAR PATEL
Mother's Name : ANJANAKUMARI MUKESHKUMAR PATEL
Date of Birth : 16/04/2005 Gender : Female
Category : SEBC Religion :Hindu
Caste : Koli Ds`
Aadhaar Status Verified: Yes(12/11/2024 23:05:48)
Annual Income of Parents/Guardian/Husband (Rs): 89000 Habitation Type: Urban
Mobile Number : 8160645867 E-mail Address : helympatel164@[Link]
Aadhar No : 47xxxxxx5955 Parent/Guardian occupation: Labour(\ȩl^
Is Orphan: NO Day Scholar / Hosteller : Hosteler
Marital Status : Unmarried Hostel Type: Government Hostel
Current Address: Permanant Address:
State Gujarat State Gujarat
District Jamnagar District Navsari
Taluka Jamnagar Taluka Gandevi
Village Village
PinCode PinCode 396310
Address:New & Old ladies hostel Address:Bhatha, lali faliya
Shri M.P. shah medical College jamnagar
Student Bank Account Detail/Aadhar Bank Detail
I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 47xxxxxx5955 Bank name : -
Mandate Date : 11/12/2024 12:00:00 AM Status : Accept
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 29xxxxxx4866 IFSC Code : BKID0002905
Student Name(As per Bank Name): HELI MUKESHKUMAR PATEL
Name of Bank : BANK OF INDIA
Branch Name & Address : BILIMORA
I hereby accept that
[Link] provided by me are correct to best of my knowledge
[Link] not make any claims if amount is transferred to a wrong account due to incorrect details provided by me
[Link] refund the amount transferred to someone else¶s account due to incorrect details provided by me
4.I will refund the excess amount credited to my account, if any.
Student Academic Details
Present Course/Class/Trade Type: Medical
Present Course/Class/Trade Name : MBBS Bachelor of Medicine and Bachelor of Surgery
Present Course/Class/Trade Year : 1ST YEAR(1st Semester/2nd Semester)
Courtesy :: National Informatics Centre, Gujarat Page 1 of 3 242500000000026410 Print Date :21/11/2024
Studying in : Gujarat Enrollment No:
Present Institute District : Jamnagar Present Institute : M.P. SHAH MEDICAL COLLEGE, JAMNAGAR
Admission Type : Regular Seat(Government Quota) Present Course Branch : -
Present Class Start Date : 17-Sep-2024 Present Course Completion Date : 17-Sep-2025
Hostel Detail
Is Hostel run by Department Yes
Is Hostel attached With College Yes
Free facilities provided by Hostel? No
Educational Break : No No. Of. Year in Break :
Previous Education Detail
Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH Science B8359718 2020 88.67
11th Std/12 Std 12TH Biology B185266 2022 92.62
Medical MBBS Bachelor of Medicine and Bachelor of 1st year MBBS 23MD001 2024 70.71
Surgery UG00375
List of documents which you have attached :
1 Caste Certificate From the Competent Authorities
2 First Page Of Bank PassBook/Cancelled Cheque
3 Fee Receipt of Current Course Year
4 Hostel Certificate(Only For Hosteller Student)
5 Income Certificate (Competent Authority)(Form no.16 required For Govt. Employee)
6 School Leaving Certificate (If Any)
I have read all above terms and conditions and understand them fully, I hereby declared that here I am submitting only one
application for scholarship and I haven¶t received any other scholarship/stipend or fellowship in this current session under any other
central/state government scheme. I further state that all information furnished by me is correct to my knowledge in case of any the
false information or suppression of necessary data proved in my application is liable to get cancelled at any stage of the scholarship
process and the entire amount of scholarship will be refunded by me or recovered from me. Government decision shall be final and
binding on me.
Verify Mobile Number: Yes 21/11/2024
Place : Signature of the applicant
Date : 21/11/2024
It is certified that the information filled in the above mentioned fields by the students are correct to the best of my knowledge and all
the Documents has been checked.
It is also certified that in case the applicant leaves institution or otherwise discontinues the studies or detained or accepts any other
regular scholarships/stipend/ fellowship the fact will be immediately reported to the said authority
Certified that the student is eligible for scholarship amount subject to Central/State government rules and the student is
recommended for sanction of scholarship.
Courtesy :: National Informatics Centre, Gujarat Page 2 of 3 242500000000026410 Print Date :21/11/2024
This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2024
-[Link] student will irregular, than we will immediately reported to the said authority.
The actual School/College/University year began on __________________ and will be ended on _____________________
Date : Signature Of Head Of The School/College/Institute/University With Official Seal
Place :
*Note : Stamp Signature will not be accepted
Courtesy :: National Informatics Centre, Gujarat Page 3 of 3 242500000000026410 Print Date :21/11/2024