10/1/23, 8:48 PM Review & Print
RECEIPT COPY OF ONLINE APPLICATION
UNIVERSITY OF CALCUTTA
UNIVERSITY OF CALCUTTA , 87/1, COLLEGE STREET , KOLKATA , 700073
Application Form
Academic Session: 2023-24
APPLICATION / FORM NO: 230904204642
Application / Form No 230904204642 Course Name M.SC/B.Tech
No of Group(s) 2 Group(s) 201 (ECE), 222 (MRSC)
Amount Fee Waived Type CU
SELECTED SUBJECT(S) WITH INSTITUTES AND ORDER OF PREFERENCE
1. 201 (ECECU), 2. 201 (EECU), 3. 201 (OOECU), 4. 201 (ESCU), 5. 201 (ESDA), 6. 201 (PHCU), 7. 201 (ITCU), 8. 201 (IECU), 9.
201 (PHGD), 10. 201 (PHVK), 11. 222 (MRSCCU)
PERSONAL DETAILS
Applicant Name SAYAN MUKHERJEE Date of birth 24-02-2002
Mother's Name CHANDRIMA MUKHERJEE Father's Name KANCHAN MUKHERJEE
Mother's Occupation HOME MAKER Father's Occupation BUSINESS/ENTREPRENEURSHIP
Mother's Father's
BA BCOM
Qualification Qualification
Mother's Mobile Father's Mobile
7865994569 7003065037
Number Number
Relation with
Guardian's Name KANCHAN MUKHERJEE FATHER
Guardian
Guardian's Mobile
7003065037 Guardian's Email SAYANMUKHERJEE.BN@GMAIL.COM
No.
Alternate Mobile
Mobile Number 9382715508
Number
Email Id sayanmukherjee.bn@gmail.com Gender MALE
Category GENERAL Nationality INDIAN
Religion HINDUISM Aadhar No. 4585-8992-3914
Marital Status UNMARRIED Empl Status UNEMPLOYED
Locality RURAL PWD NO
Family Income 60000.00 BPL NO
Domicile of WB NO EWS NO
Sports Quota NO Blood Group B+
KHALORE, PO BAGNAN,BAGNAN,BAGNAN,BAGNAN,BAGNAN I,HOWRAH, INDIA, WEST
Permanent Address
BENGAL, 711303
KHALORE, PO BAGNAN,BAGNAN,BAGNAN,BAGNAN,BAGNAN I,HOWRAH, INDIA, WEST
Present Address
BENGAL, 711303
PREVIOUS ADMISSION DETAILS
Whether Admitted in Last Year or Not? NO
ACADEMIC QUALIFICATIONS
Div./Class Obtained Full Percentage Year of College/School Board/University
Sl Examination Passed Status
CGPA
awarded Marks Marks of Marks Passing Name Name
BAGNAN
1. SECONDARY PASSED FIRST NO 633.00 700.00 90.43 2018 HIGH WBBSE
SCHOOL
BAGNAN
HIGHER
2. PASSED FIRST NO 447.00 500.00 89.40 2020 HIGH WBCHSE
SECONDARY/INTERMEDIATE
SCHOOL
ULUBERIA
3. B.A/B.SC/B.COM PASSED FIRST NO 2149.00 2600.00 82.65 2023 CU
COLLEGE
HS(10+2)/INTERMEDIATE MARKS DETAILS
# Subject 1 Subject 2 Subject 3 Subject 4 Subject 5 Subject 6
Name ENGLISH PHYSICS MATHEMATICS CHEMISTRY BIOLOGY NONE
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Theory
70 61 68 61 60 0
Marks
Practical
20 27 20 30 30 0
Marks
Full
100 100 100 100 100 0
Marks
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10/1/23, 8:48 PM Review & Print
RECEIPT COPY OF ONLINE APPLICATION
UNIVERSITY OF CALCUTTA
UNIVERSITY OF CALCUTTA , 87/1, COLLEGE STREET , KOLKATA , 700073
Application Form
Academic Session: 2023-24
APPLICATION / FORM NO: 230904204642
UG MARKS DETAILS(1+1+1 MARKS DETAILS)
# Hons Subject Gen/Pass/GE Subject(s)
NAME PHYSICS MATHEMATICS CHEMISTRY
Marks
1608 193 158
Obtained
Full
2000 200 200
Marks
Percentage 80.4 96.5 79
I , SAYAN, hereby declare that all the particulars stated by me in this Application Form are true to the best of my knowledge and belief. I have read the relevant Information Brochure &
Admission Schedule pasted on the University website / Printed Hard Copy / Notice Board for admission . I shall abide by the terms and conditions therein. It is entirely my responsibility to
prove my eligibility for admission to the Programme to which I am admitted and also in respect of qualifications and entitlement for admission against reserved category, if claimed, to the
satisfaction of the University . Further , in the event of suppression or distortion of any fact like category , educational qualifications, nationality, etc. made in my Application Form , I understand
that my admission, if granted or degree acquired subsequently , is liable for cancellation. I also understand that the decision of University of Calcutta regarding my admission will be final and I
shall abide by the rules and Regulation of University of Calcutta from time to time.
ENCLOSURES
(i) Copy of Admission Receipt
(ii) Self Attested true copies of marks-sheets of all the examinations passed
( 10th Standard onwards.)
(iii) Proof of Date of Birth Certificate.
(iv) SC/ ST / PWD / OBC-A / OBC-B/ Domicile Certificate, if applicable.
(v) Copy of aadhaar card.
Application Date : 04-09-2023 Signature :
Signature with Date
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