Kashi Naresh Government PG College, Gyanpur,
Bhadohi
Under-Graduate/Certificate/Diploma (UG) Admission Form
SESSION (2025-26)
Registration : 25BZC01400 Reg. Date : 10 July, 2025 05:16:18 pm
University [Link]. : MVVURN2500013952 University Form Payment Date : 10 July, 2025
1. Department / Course Application Choices : Index : 59.6
# Degree Payment #
1 [Link]. (Bio.) - I Semester Paid Rs.0 on 10/07/2025 # 0000000000
2. Candidate's Name ANCHAL YADAV
3. Father's Name DINESH KUMAR YADAV
4. Mother's Name MEERA DEVI
5. Date of Birth 26-10-2006 6. Gender Female
7. Caste/Category O.B.C. 8. Sub-Category Not applicable
9. Domicile Uttar Pradesh 10. Religion Hindu
11. Caste Certificate # N/A 12. Income Grp Not Applicable
13. Domicile Cert. # 681212057974 14. Minority NO
15. Nationality Indian 16. Blood Group Do not know/Not Sure
17. EWS Status Does not belong to EWS
18. Address for Correspondance : 19. Address for Correspondance :
MADARIPUR RAJPURA BHADOHI, MADARIPUR RAJPURA MADARIPUR RAJPURA BHADOHI, MADARIPUR RAJPURA
BHADOHI, Bhadohi, Uttar Pradesh - 221401, India BHADOHI, Bhadohi, Uttar Pradesh - 221401, India
Weightage Information
20. Weightages :
Other Passed 12th From Bhadohi District YES
Rovers/Rangers Basic / Praveen Course NO
Rovers/Rangers Vishwavidyalay Samagam / Nipun Praman Patra NO
Rovers/Rangers Prantiya Samagam / Rastrapati Puraskar NO
N.C.C. B Certificate NO
N.C.C. C Certificate NO
N.C.C. RD Certificate NO
N.S.S. Two Years Membership and One Special 10 Days Camp NO
1
N.S.S. Two Years Membership and Two Special 10 Days Camp NO
Sports Inter School Zonal Sports NO
Sports State Level National Competition NO
Total Weightage : 5 Awarded Weightage : 5
21. Academic Record :
Examination Year Max Obt. Roll No. Stream Board %
U.P. Board of High School &
10th 2023 600 417 / 600 1232515646 Not Applicable 69.5 %
Intermediate Education, Allahabad.
U.P. Board of High School &
12th 2025 500 273 / 500 2257118792 PCB 54.6 %
Intermediate Education, Allahabad.
22. AADHAAR No. 334493693869 23. N.A.D. Number
NOTE: Mark the number of documents ( Photocopy/Xerox) attached by the Candidate during counselling
Xth Marksheet Xth Certificate
XIIth Marksheet Last Exam Passed Marksheet
Recent Passport Sized Photograph Domicile (for other state)
Certificate for Horz./Reservation Category Certificate for Vert./Caste Category
Weightage Certificates (if applicable) E.W.S. Certificate (if applicable)
Declaration
I solemnly declare that all the information made above are true to the best of my knowledge and belief. If any information is
found incorrect, my condidature can be cancelled.
Signature of Parent/Guardian Signature of Candidate
Date:
Date:
Printed: Wednesday, July 30, 2025 11:04 am
For Office Use Only
Signature of Admission Committee Signature of Principal
2
(College Copy)
Kashi Naresh Government PG College, Application
Gyanpur, Bhadohi Form No.
25BZC01400
Counselling Letter (2025-26)
महािवालय पिरसर म माक और ह ड सै िनटाइजर का योग अिनवाय है ।
वे शाथी आवे दन प की हाड कॉपी, हाईकू ल इं टरमीिडएट अं कप, टी० सी० / चिर माण प एवं तीन रं गीन पासपोट साइज फोटो समत
सलनको की मूल छाया ित काउं सिलं ग के समय अवय साथ लाये
A. Student Details Index : 59.6
Course: [Link]. (Bio.) - I Semester
Faculty: BIO
Major : (Zoology ),( CHEMISTRY)
Minor Subject: BOTANY
Skill
BUSINESS ENGLISH
Development:
Co-Curricular: Food , Nutrition And Hygien
University
MVVURN2500013952
[Link]. :
University Form
10 July, 2025
Payment Date :
Candidate's
ANCHAL YADAV
name:
Father's name: DINESH KUMAR YADAV
Mother's name: MEERA DEVI
Guardian's
DINESH KUMAR YADAV Relation: Daughter
Name:
Date Of Birth: 26-10-2006 Gender/Sex: Female
Category: O.B.C.
Domicile Uttar Pradesh
Residential Address Permanent Address
Address : MADARIPUR RAJPURA BHADOHI, Address : MADARIPUR RAJPURA
MADARIPUR RAJPURA BHADOHI BHADOHI, MADARIPUR
State : Uttar Pradesh RAJPURA BHADOHI
District : Bhadohi State : Uttar Pradesh
Pin Code : 221401 District : Bhadohi
Pin Code : 221401
Phone : 9621797872 Aadhar No. : 334493693869
Email : ujjwalyadav07072007@[Link]
Payment Details
Payment Mode: online Bank: online Fee: 4079
Payment Date: 30-07-2025 Transaction ID : 11000289690137
F. Declaration
I solemnly declare that all the information made above are true to the best of my knowledge and belief. If any information
is found incorrect, my candidature can be cancelled.
Signature of the Candidate
Signature of Father/Guardian
For Office Use Only
Signature of Admission Committee Signature of Proctor Signature of Principal
3
(Proctor Copy)
Kashi Naresh Government PG College, Application
Gyanpur, Bhadohi Form No.
25BZC01400
Counselling Letter (2025-26)
महािवालय पिरसर म माक और ह ड सै िनटाइजर का योग अिनवाय है ।
वे शाथी आवे दन प की हाड कॉपी, हाईकू ल इं टरमीिडएट अं कप, टी० सी० / चिर माण प एवं तीन रं गीन पासपोट साइज फोटो समत
सलनको की मूल छाया ित काउं सिलं ग के समय अवय साथ लाये
A. Student Details Index : 59.6
Course: [Link]. (Bio.) - I Semester
Faculty: BIO
Major : (Zoology ) , ( CHEMISTRY)
Minor Subject: BOTANY
Skill
BUSINESS ENGLISH
Development:
Co-Curricular: Food , Nutrition And Hygien
University
MVVURN2500013952
[Link]. :
University Form
10 July, 2025
Payment Date :
Candidate's
ANCHAL YADAV
name:
Father's name: DINESH KUMAR YADAV
Mother's name: MEERA DEVI
Guardian's
DINESH KUMAR YADAV Relation: Daughter
Name:
Date Of Birth: 26-10-2006 Gender/Sex: Female
Category: O.B.C.
Domicile Uttar Pradesh
Residential Address Permanent Address
Address : MADARIPUR RAJPURA BHADOHI, Address : MADARIPUR RAJPURA
MADARIPUR RAJPURA BHADOHI BHADOHI, MADARIPUR
State : Uttar Pradesh RAJPURA BHADOHI
District : Bhadohi State : Uttar Pradesh
Pin Code : 221401 District : Bhadohi
Pin Code : 221401
Phone : 9621797872 Aadhar No. : 334493693869
Email : ujjwalyadav07072007@[Link]
Payment Details
Payment Mode: online Bank: online Fee: 4079
Payment Date:30-07-2025 Transaction ID : 11000289690137
F. Declaration
I solemnly declare that all the information made above are true to the best of my knowledge and belief. If any information
is found incorrect, my candidature can be cancelled.
Signature of the Candidate
Signature of Father/Guardian
For Office Use Only
Signature of Admission Committee Signature of Proctor Signature of Principal
4
(Student Copy)
Kashi Naresh Government PG College, Application
Gyanpur, Bhadohi Form No.
25BZC01400
Counselling Letter (2025-26)
महािवालय पिरसर म माक और ह ड सै िनटाइजर का योग अिनवाय है ।
वे शाथी आवे दन प की हाड कॉपी, हाईकू ल इं टरमीिडएट अं कप, टी० सी० / चिर माण प एवं तीन रं गीन पासपोट साइज फोटो समत
सलनको की मूल छाया ित काउं सिलं ग के समय अवय साथ लाये
A. Student Details Index : 59.6
Course: [Link]. (Bio.) - I Semester
Faculty: BIO
Major : (Zoology ),( CHEMISTRY)
Minor Subject: BOTANY
Skill
BUSINESS ENGLISH
Development:
Co-Curricular: Food , Nutrition And Hygien
University
MVVURN2500013952
[Link]. :
University Form
10 July, 2025
Payment Date :
Candidate's
ANCHAL YADAV
name:
Father's name: DINESH KUMAR YADAV
Mother's name: MEERA DEVI
Guardian's
DINESH KUMAR YADAV Relation: Daughter
Name:
Date Of Birth: 26-10-2006 Gender/Sex: Female
Category: O.B.C.
Domicile Uttar Pradesh
Residential Address Permanent Address
Address : MADARIPUR RAJPURA BHADOHI, Address : MADARIPUR RAJPURA
MADARIPUR RAJPURA BHADOHI BHADOHI, MADARIPUR
State : Uttar Pradesh RAJPURA BHADOHI
District : Bhadohi State : Uttar Pradesh
Pin Code : 221401 District : Bhadohi
Pin Code : 221401
Phone : 9621797872 Aadhar No. : 334493693869
Email : ujjwalyadav07072007@[Link]
Payment Details
Payment Mode: online Bank: online Fee: 4079
Payment Date:30-07-2025 Transaction ID : 11000289690137
F. Declaration
I solemnly declare that all the information made above are true to the best of my knowledge and belief. If any information
is found incorrect, my candidature can be cancelled.
Signature of the Candidate
Signature of Father/Guardian
For Office Use Only
Signature of Admission Committee Signature of Proctor Signature of Principal
5
रै िगंग िनरोध शपथ प
का : [Link]. (Bio.) - I Semester
महािवालय अनु मांक
से वा म ,
ाचाय,
काशी नरे श राजकीय नातकोर महािवालय,
ानपु र भदोही।
1. म ANCHAL YADAV पु /पु ी DINESH KUMAR YADAV िनवासी Bhadohi िजला Bhadohi काशी नरे श
राजकीय नातकोर महािवालय ानपु र की का [Link]. (Bio.) - I Semester 2025-26 म वे श ले रहा हँ ।ू म ने
र िगं ग िनषे ध के िविध/उचतम यायालय तथा कदीय राय सरकारी उच िशा सं थान म र िगग रोकने से सबं िधत
िविनयम २०१४ की एक ितिलप ात कर ली है तथा उसे यान से पढ़ िलया है ।
2. म ने मु य प से िवनयम 3 को पढ़ व समझ िलया है और मै यह जानता /जानती हँ ू की रै िगं ग के या मायने ह |
3. म ने धारा 7 तथा 9.1 को समझ िलया है | अगर मै िकसी तरह की रै िगं ग के िलए िकसी को उकसाता हू या िकसी तरह की
रै िगं ग म भाग ले ता हँ ू तो शासन मे रे िखलाफ दं डामक कायवाही कर सकता है |
4. मै िनचय पूवक यह यन कँगा /कंगी िक -
क- मै िकसी भी रै िगं ग जो धारा 3 िविनयम मे उले ख है उसमे िलत नही होउँ गा/होउँ गी |
5. मै िकसी भी कार की रै िगं ग म भाग नही लूँगा/लु ं गी अथवा िकसी भी कार से रै िगं ग का चार नहीं कँगा /कँ गी |
6. मै यह घोिषत करता /करती हँ ू िक अगर मै रै िगं ग के मामले मे दोषी पाया गया /पायी गयी तो मु झे िविनयम 91 के अनु सार
दं िडत िकया जा सकता है | इससे अितिरत कानूनी ावधान के अतगत अपरािधक गितिविधयो म िव दं डामक कायवाही
िकया जा सकता है |
मै यह घोिषत करता/करती हँ ू िक मे रे िवद दे श के िकसी भी सं था ारा रै िगं ग के मामले म ितबध नहीं लगाया गया है यिद
ऐसा पाया जाता है तो मे रा वे श िनरत िकया जा सकता ह |
िपता अिभभावक का हतार
शपथकता /अयथी का हतार
िदनांक-
6
Available Subject Combinations (Major and Minor)
[Link]. Major 1 Major 2 Minor
1 Zoology BOTANY CHEMISTRY
2 Zoology CHEMISTRY BOTANY
3 BOTANY CHEMISTRY Zoology