RADHA GOVIND UNIVERSITY
RAMGARH, JHARKHAND
EXAMINATION FORM Paste P.P. Size
Coloured
Photograph
lsok esa]
ijh{kk lapkyd]
jk/kk xksfoUn fo”ofo|ky;] jkex<+A
Candidate Signature
egk”k;]
jk/kk xksfoUn fo”ofo|ky; }kjk vk;ksftr l=------------------------------------ ds ---------------------------------- lsesLVj ijh{kk---------------------- dh
ijh{kk esa cSBus dh vuqefr dk @ dh izkFkhZ gw¡A
ijh{kkFkhZ dk fooj.k ¼ ijh{kkFkhZ dk gLrk{kj ½
1- ADMISSION NO. :............................................................, Date of Admission...........................
2- NAME OF THE STUDENT :.....................................................................................................................
¼ijh{kkFkhZ dk uke½ :.....................................................................................................................
¼nsoukxjh fyfi esa½
3- FATHER’S NAME :.....................................................................................................................
¼ijh{kkFkhZ ds firk dk uke½
4. MOTHER’S NAME :.....................................................................................................................
¼ijh{kkFkhZ ds ekrk dk uke½
5. DATE OF BIRTH :............................................................, 6. GENDER :..................................
¼tUe frfFk½ ¼fyax½
7. CATEGORY :............................................................,
¼[Link]½
8. CORRESPONDENCE ADDRESS :................................................................................................................
¼OkÙkZeku irk½ ......................................................................................................................
.........................................................................., PIN ...................................
Aadhar No...................................................., Mobile No................................
E-mail Id :.....................................................................................................
9. NAME OF THE DEPARTMENT :.................................................................................................................
¼foHkkx dk uke½
10. UNIVERSITY ROLL NO. :............................................................,
¼fo”ofo|ky; ijh{kk vuqØekad½
11. REGISTRATION NO. :............................................................, 12. CLASS ROLL NUMBER :............
¼ iath;u la[;k ½ ¼oxZ vuqØekad½
13. Subject of Examination :........................................................., ..........................................................
¼ijh{kk dk fo’k;½ :........................................................., ..........................................................
:........................................................., ..........................................................
:........................................................., ..........................................................
ijh{kk izi= “kqYd %
ijh{kk “kqYd :i;s %
foyEc “kqYd :i;s %
dqy :i;s % tk¡p djus okys iz/kkukpk;Z@foHkkxk/;{k dk
f”k{kd dk gLrk{kj gLrk{kj ,oa eqgj
Tkk¡p djus okys vf/kdkfj;ksa@f”k{kdksa ls vuqjks/k
1- ;g vuqjks/k fd;k tkrk gS fd izsf’kr vf/kdkjh@f”k{kd bl ckr dks lko/kkuh ds lkFk ysa fd ijh{kkFkhZ dk uke vkosnu i=
esa Bhd mlh rjg eqfnzr gS tSlk mlds eSVªhdqy”s ku ;k ek/;fed ijh{kk ds izek.k&i= (Certificate) vkSj fo”ofo/kky; dh
iath;u (Registration) jlhn esa vafdr gSaA
2- Oks d`Ik;k ;g Hkh ns[k ysa fd ijh{kkFkhZ dk iath;u la[;k] fo’k; RkFkk vU; fooj.k Bhd&Bhd eqfnzr gS ;k ughaA Hkfo’; esa
fdlh rjg dh xyrh ik;s tkus ij tk¡p djus okys vf/kdkjh vkSj foHkkxk/;{k@izkpk;Z gh ftEesokj gksaxsA
Ikzek.k&i= (Certificate)
¼>kj[k.M jkT; fo”ofo|ky; vf/kfu;e ¼la”kksf/kr½ ,oa ifjfu;e }kjk iznÙk½
dkWyt
s ds fu;fer ¼dkWysft,V½ Nk=ksa ds fy,
eSa [Link] djrk@djrh gw¡ fd vkosnd us esjs lkeus--------------------------------------------------------------------------------------------------- fo”ofo|ky; }kjk
iznÙk izek.k i= mifLFkr djds eq>s ifjrq’V dj fn;k gS fd ;s---------------------------------------------------------------------------------------------------
fo”ofo|ky; dh Lukrd izfr’Bk@lkekU; Hkkx 1@2@3 dh ijh{kk ikl dh ;k fo}r ifj’kn~ }kjk mldh led{k------------------
-----------------------------------------------ijh{kk esa mÙ[Link] gks x;s gSa] ,oa bUgksaus lEcfU/kr foHkkx dkWystksa esa fu;fer :Ik ls v/;;u dj Lukrd
izfr’Bk@lkekU; 1@2@3 LukrdksÙkj Hkkx 1@2 dh ijh{kk ds fy, fu/kkZfjr ikB~;Øe dks iwjk dj fy;k gS vkSj tgk¡ izk;ksfxd
¼izSDVhdy½ ijh{kk dk fo/kku gS ogk¡ vius lkjs v/;;u dky esa fu/kkZfjr iz;ksxksa dks Hkh lq;ksX; funsZ”ku esa leqfpr :Ik ls lEiUu
fd;k gSA budk vkpj.k vPNk jgk gSA bUgksaus fu;fer :Ik ls v/;olk;iwoZd v/;;u fd;k gS rFkk os ifjfu;eksa ¼jsxqys”ku½
esa fufnZ’V dkWyst dks vkof/kd ¼ihfj;ksfMdy½ RkFkk vU; ijh{kkvksa esa lfEefyr gq, gSa vkSj mlesa mÙ[Link] gq, gSa rFkk ml vkosnu
i= esa bUgksua s ftu fo’k;ksa dk mYys[k fd;k gS mUgsa ysdj ;s bl ijh{kk esa lfEefyr gksus ds vf/kdkjh gSa] rFkk bUgksaus ftu fo’k;ksa
esa O;k[;kus] vH;kl rFkk iz;ksx d{kkvksa ¼V~;wVksfj;yksa vkSj izSfDVdy Dyklksa½ dh fu/kkZfjr mifLFkfr la[;k iwjh dj yh gS] rFkk
bUgksaus bl vkosnu&i= ij esjs lkeus vFkok esjs }kjk blds fy, vf/kd`r O;fDr ds lkeus viuk gLrk{kj fd;k gS rFkk eSa buds
uSfrd pfj= ds fo:) dqN ugha tkurk vkSj eq>s fo”okl gS fd bUgksaus bl vkosnu&i= esa tks fooj.k fn;s gSa os Bhd gSA
Lukrd@LukrdksÙkj ds Hkkx---------------------------------------esa mifLFkfr dh izfr”kr-------------------------------gSA
frfFk %-------------------------------------- tk¡p djus okys f”k{kd dk gLrk{kj foHkkxk/;{k@izkpk;Z
dkWyst ds ,Dl dkWysft,V ijh{kkfFkZ;ksa ds fy,
eSa [Link] djrk gw¡ fd vkosnd us esjs lkeuss--------------------------------------------------------------------------------------------------- fo”ofo|ky; }kjk iznŸk
izek.k&i= mifLFkr dj eq>s ifjrq’V dj fn;k gSa fd jk/kk xksfoUn fo”ofo|ky; }kjk vk;ksftr------------------------------------------------
ijh{kk--------------------------------------- esa lfEefyr gq, Fks@;k lfEefyr ugha gq, Fks] ftlesa [Link] gks x;s gaSA bUgksaus-------------------------------
-------------------------- ijh{kk---------------------------------------- esa lfEefyr gksus gsrq ijh{kk QkWeZ Hkjk@Hkjh gSA bUgksaus iwoZ esa lfEefyr ijh{kk dk
izos”k&i= ,oa ukekadu lac/a kh nLrkost fn[kkdj eq>s ifjrq’V dj fn;k gS fd mi;qDr ijh{kk ds l=------------------------------------------ esa
vfHkZd`fr dh gSA buds uSfrd pfj= ds fo:) dqN ugha tkurkA bUgksaus bl vkosnu&i= ij esjs lkeus gLrk{kj fd;k gS vkSj
esjk fo”okl gS fd budk vkpj.k vPNk jgk gS vkSj bUgksua s v/;olk;iwoZd fu;fer :Ik ls v/;;u fd;k gS rFkk bl
vkosnu&i= esa tks fooj.k fn;s gSa os Bhd gSAa ¼izk;ksfxd d{kk okys Nk=ksa dks 6 efguk iz;ksfxd Dykl djuk vfuok;Z gSA½
---------------------foHkkxk/;{k@izkpk;Z
frfFk %-------------------------------------- tk¡p djus okys f”k{kd dk gLrk{kj ----------------------------------------------dkWyt
s
uksV % lHkh ijh{kkfFkZ;ksa dk vkosnu&i= lEcfU/kr ladk; ds foHkkxk/;{k@izkpk;Z }kjk izsf’kr gksuk vko”;d gS vU;Fkk
vkosnu&i= Lohdk;Z ugha fd;k tk;sxkA