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CNET 2024 B.Sc. Nursing Application Form

The document is the final print of the application form for the Common Nursing Entrance Test (CNET) 2024 for a B.Sc. Nursing program. It contains personal details, academic qualifications, preferences for examination cities, and bank account information for refunds. The candidate, Shabana Khatoon, has provided a declaration affirming the accuracy of the information submitted.

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shabanakhatoon639126
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18 views2 pages

CNET 2024 B.Sc. Nursing Application Form

The document is the final print of the application form for the Common Nursing Entrance Test (CNET) 2024 for a B.Sc. Nursing program. It contains personal details, academic qualifications, preferences for examination cities, and bank account information for refunds. The candidate, Shabana Khatoon, has provided a declaration affirming the accuracy of the information submitted.

Uploaded by

shabanakhatoon639126
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

Common Nursing Entrance Test (CNET) 2024

[Link]. Nursing (4 Years) APPLICATION FORM (FINAL PRINT)

Registration Id No. : 124087750

Application Id 48039534 Application Date 13-05-2024 01:12:31


Transaction Id pay_O9shQ1XCxJlQSL Transaction Date 2024-05-13 12:06:38
Bank Reference No . order_O9sfiNFPqhcmZy Paid Amount 3000

Personal Details

Name SHABANA KHATOON Father/Husband Name MD SADULLAH


Mother Name KAMRUN NISHA KHATOON Gender FEMALE
Date of Birth 15/07/2006 Age on (December, 31, 2024) 18 YEARS, 5 MONTHS & 16 DAYS.
Place of Birth MADHUBAN Nationalit y INDIAN
Mobile No . 6391265232, 9451419223(Alternate) Email AADILSHAIKH786092@[Link]
Categor y OBC (OTHER BACKWARD CLASSES) Sub-Categor y NA

Address

Permanent Address

House No ./ Street / Village JAMIN MANAULI Mohalla / Area / Post Office MADHUBAN
Cit y MAU State UTTAR PRADESH
Pincode 221603
Full Address for Correspondence

House No ./ Street / Village JAMIN MANAULI Mohalla / Area / Post Office MADHUBAN
Cit y MAU State UTTAR PRADESH
Pincode 221603

Academic Qualifications

x
E amination Board / Institute / Passing Ma x. Obtained % of

Passed Universit y College Year Marks Marks Marks Subjects

High School UP BOARD SUBHAGI DEVI 2021 600 518 86.33 HINDI,
INTER ENGLISH,BIOLOGY,CHEMISTRY,PHYSICS,SOCIAL
COLLEGE SCIENCE
MADHUBAN
MAU
Intermediate UP BOARD SUBHAGI DEVI 2023 500 368 73.60 BIOLOGY,CHEMISTRY,PHYSICS,ENGLISH,HINDI
INTER
COLLEGE
MADHUBAN
MAU
x
E amination x
Ma imum Marks Obtained marks x
E amination x
Ma imum Marks Obtained marks

Biology 100 78 Physics 100 62


Chemistry 100 85 English 100 53

x
E am Cit y Preference
Preference 1: AZAMGARH Preference 2: GORAKHPUR Preference 3: VARANASI

Bank Account Details for Refund

Account No . as per Bank 462802120002662 Name as per Bank SABANA IFSC Code as per Bank UBIN0546283
Record : Record : KHATOON : Record

Name of Bank : UNION BANK OF State : UTTAR PRADESH District : MAU


INDIA
Common Nursing Entrance Test (CNET) 2024
[Link]. Nursing (4 Years) APPLICATION FORM (FINAL PRINT)

Registration Id No. : 124087750

PASSPORT SIZE PHOTO & LIVE PHOTO

VERIFICATION PROFORMA

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)

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