Scrutiny 01 NEW

Download as pdf or txt
Download as pdf or txt
You are on page 1of 3

NAND(UIVIAf SiNGH CHOUHAN GOVERNMENT MEDICAL COLLEGE, (HANDWA

BIoMETERIx / PHgocRAPH: v!!_!IlsD / NoTvtRlrraD


Nam€ & Slgnature oI Phorosrf ph ver Iy nE olfi.er

CERIIFICATE OF SCRUTINY COM M ITTEE


PARTICULARS & DECLARATION OF THE CANOIDATEFOR MSSS
BA'CH 2024-2025

lro0rHtr[D Nsyrr]EcaNDoArErNBLocKtrrrERs)
' ulr o.--r({D.o. - ERJU\ lq )(LA
06 O12oOq sbodc,ouo O'v? NAroNALl]Y l1!ro AN
REIIJA _ qA0HA-/ PP-AlEstl
q 21tO5 55Y SHUKLAAARJUNU qq @6fiAIL.(I)M
srarE / | COINOM N!E/ STAIE

.(itvr.rou.rr*t l.,R
MP/ TF,I PBl 4NOCLA(s SN
rsNAME lHAq1!L)A].r pcASA) SrruKLA
^rfr qq5\53I5'1
olsHUKL,A\l 56 0 E^4AIL.CO|4
MOT T33N^ME MAF1TA SHUKLA
MorHE(r E.MA1!& Mostrr No 8lr?qq 4211

NaAR TALAS, a.eAM PTP^RL0A(, PosT


I"\AHMOOITPOR HAHAMOIPI)R . IlELUA . I'' AO VA PLAl\istr!,''5III
qq5q 5t lt 5q
occ P^IoN, FATHTI ARH MorrER Hou(ELoLFE

i dnr, ,,f! { 3id / or rhc t


e byr€ D redor. rr!d GLrdr on/Dar/prrupi d,i!fntru,rn

r'\-Nr-
sisnatureYNahe6iparenl Slsnature & Name of Candidare
BT1Ah1.4A$,,,,Pi4:8-o,.,S,HUKLA ARJ!A] SH]-]KtA
D*.,-...31:.9:9-.19?!
I'OI,T.O\1'ING ORICI:\AI- DOC U [I }:N'I'S ARE BDINC ST]BM IITED BY ]'II I C,\:IDIDA'I'I
Nrrnc or('uncii<larc ARJUN SUUKI-J s/OoR D/o- BH6-hgj-AN pPASA! StluKLA

lss!inr Bodl

onhnrrnin Pcdc !l Rugistrorion


NTA 2q o\a t0?63631 2o-02,2 NtR
I/
t1l02l"l5
LntNgqt
DHE 3ooq ozo t?2 3o-or-: DIV\'E
NTA 2r.toqlol 63631 26-Dt -2( S0 0.,1A)

NTA 3 ooq o2o I t2 09-05'2q S O(Nr ;/


cEsE 22 6+2C E 05-051r coE -J/
A PS l.).r'c I -o3- !-o PRIN cIPAL -r/
lut:h..r& (c ilicrrc CBSE r36 2518+ 3o-o+'21 coE
,,,.r1"r fr"*,f ."r * l,,rirr,rlrr' --
LSK C.slqso,or rolsrss'l r orr- oi-ir-rz q.s
irxl( Allnhv r rr.! n.'r 4r
NOTARY tLlq 6 lo.0t-2tr N OTA&Y
1 ."rlri".rc TE HStu PsltJo lor xrlal5 3 6 ?r 2q 2a-06-2Y e\iildch ,y
7
l

6oI ?tol qqq 5 qqvt ol -11-20 (^01


( uliil!urc (DiBiul) yh
ccrliieirs ifl rny on notrjudicinl
NOT AR Y tqqS r& d-2't tro-tAfY /
!l lts 5l)r wlri.h is ltude b)

CBSE t 23+Ao+ )r -o:1"1r Aa6 J/


ADs.li. 36 t SA- q-68-21 Pn tNr r PAr

L /( ollcs,r L-cuvirlg ccfi ificar.


APS Jr.c tqqqt -6t.21 pprNclrAL
lcuri I;.1:,l\4 PiP H/l;wS/ Prooloi Vo
J[o\]ry! lin!ll$tCard lloldcr
L.Rqqr2q2,
:-
alllur(src. iliN
lcrLclntr( lScrr l!Nlng)
& lliurrl Ss^ i((,. lr'(lP Srrdrliul
,\lrldn$rrii (i00Rrr ll li_IlPcr -.
_
frrotn*V cRqqr2.qY
(t{qr2q6
-.-
cR Yq r zq3
(n. qq l2-q5
-- -- Il-o't-2\ UO'I AE\ 7
r\ir (Atrr Rxggins PircDr I
:nrsLn rll on nor judicirl st nrp ol \r'
00r whieh h rnde b! NorirY
qa,/ Alldavir ir iny on non
!ln nfolRs. 100/- shich is m de v$
at n;k{,r\'-.B- 8 tr rtr, * vD'
sr.'ia,r !'4, sln.fql 1o (sr./c)
r' lnr:s Sri lDed l:
ri -:!t lq bou o3q lEsI Ioou co ,,,
\c olill ibovc dodLuncnrs
tcgiqnft iE+drqsnsfrtqfr fr -ff rrarf+effiqqu-sqr
vs,Sqr rrR, {A +S, Eq!-sfl (q.cJ, (TqFr-0733-2245000, Far-0733-2245001
Emsll: !99!gggklegd!4agEai!s9!q, Webrire: !!!!:g!!gE!e!r!]:!4Ig

frct{ / /std snsr,/ ri.fu.aL{ll.fr.c-5r,/ 2024


............... qo-sst ffiia t- / / 2o2a
cAsr d q{q snqaff gM qisr t vqr frd ,r& W qrrfi'4-q1 i *iiifua sffur rr* yqrFm
fu-q inrcr t fo erqfi ...-... .. . -. -.........
grir e{FiR( cr{q-fiq vc.ff.0.q.s
zoz+-zs d rtcr d {Tq Fmrlafua fa esrtq sTrq frnie. / / 2024 ol q{ ri{er i sqT
&'ritg-
s.No 0escrlption OriEinal/Xerox
1 Cerlltlcal. of Scruiiny Conminee
2 grlFtq{/$n-fre'l6i qrll gqql 9TsId qFr-(3rl

3 the Conftmarion PaSe of Rctlstr tion/ Applr.ation


for N€gt 2024-25
Allotment L€tt€r lcolored cory)
5 N€et 2024 Mart 3heet/Ranl letter

7 c.nltlcar. of Ellrlblllty xerox


I 10'" Mrlk shcet& cenificate

9
-n 12"'Marl Sh€.t & Cenllicate
11 M.P. aonafide Resldent & Natlon.llty cediflcate
1l Affidavh 3ria lrrq i6I Fl.IRn EH zEr ifiq i6ll
hcome certfflcate (ParenB)
14 A.dhar Card (Orltlnal)
ia c.ste cerrifi.are {Fo.5c./sr/osc/[ws) (Dlsital)
16 Gap ce4lli.ate ln.ny on nonJudicialsirmp of
As. s0/- whrch k made bv Notaru
77 School leavlng certili.at€

18

19 rFlMP/PHl8PVGr.en aaftl
20

i Sear leavlngoond & RuralSetui.e 8on4lf Up


errderi6n then Aftldavlt on l500i5l rtanD DaDer
anti ra$ln8 aftldavlt lParenls /Stud€nt)
qqn q{,/
Affld.alt in rny on ronjudlorl strmp ofRr, l00L
$[ich k m!d! b! Notrn
2S irrrr6"q fwt e} Eqrfi q{4 + j?rn 3rrlB_d 5% *qrH
1o ls./4')
26 ganl Pars Book {of candidate/Parent) xeror
27 PHoTo,Pendrive,ENVELOPE/Oth€r Document.

i o6cuhent Ratantion Cenif i..t€


TotalNo ot original documents r Total No of xerox do€uments :.

Ffdl${ FKI${ sr&srm/qrqT{


srrq!.ti riqd s{ffi dRTr oT nI{ G srenr
di-e$d o'dRi \s ffisrq ffift ;ift .qt rnr6q ft fr rm relft -qr-o'q
n.fu.dtnRrffq frfu-ff r$frqrdq s!-ssr (q_q.)
svssr (c.q.)

You might also like