COMMON UNIVERSITY ENTRANCE

TEST CUET (PG)

Confirmation Page

Application Number 253510096614

Do Not Send this Page to National Testing Agency (NTA).
Candidate is requested to retain the printout of Confirmation page for future Reference.
यितगत योरा (Personal Detail)
उमीदवार की जम ितिथ
उमीदवार का नाम (Candidate Name) Sukhman Singh Bhatia 21-08-2004
(Candidate Date of Birth)
िपता/अिभभावक का नाम
िलंग (Gender) Male Amandeep Singh Bhatia
(Father/Guardian Name)
माता/अिभभावक का नाम
Kawaljeet Kaur Bhatia राटीयता (Nationality) Indian
(Mother/Guardian Name)
अिभभावक का नंबर (Guardian’s
9993666533
Number)
पहचान संया (Identification
पहचान का कार (Identity Type) Election Card (epic No.) sho1991835
Number)
वग (Category) General
या आप आरपीडयूडी अिधिनयम 2016 के ावधानों के अनुसार
पीडयूडी उमीदवार ह  (Are you a PwD candidate as per the NO
provisions of the RPwD Act 2016 ?)
या आपको मधुमेह ह  (Are you वािषक पािरवािरक आय (Annual
No Rs. 300001 - 400000
Diabetic?) Family Income)
रोज़गार की िथित (Status Of
Unemployed
Employment)
संपक योरा वतमान पता (Contact Details Present Address)
पिरसर संया / नाम (Premises Flat Number 104 Mansi
े  (Locality) Poothi Khoti Square
No/Name) Palace
उप-मोहला (Sub-Locality(Optional)) Near Tvs Showroom दे श (Country) India
राय/संघ (State/UT) Madhya Pradesh िज़ला (District) Indore
िपन कोड (Pin Code) 452009 मेल पता (Email Address) sukhamanbhatia1226@gmail.com
वै किपक मोबाइल नंबर (Alternate
मोबाइल नंबर (Mobile Number) +91 8519094000 9302356505
Mobile Number)
थायी पता (Permanent Address)
पिरसर संया / नाम (Premises
64 े  (Locality) Adarsh Nagar Indore Road Barwaha
No/Name)
उप-मोहला (Sub-Locality(Optional)) Front Of Raj Talkiej दे श (Country) India
राय/संघ (State/UT) Madhya Pradesh िज़ला (District) Khargone
िपन कोड (Pin Code) 451115
परीा कद और िववरण (Exam Center And Details)
के िलए आवे दन (Apply For) CUET (PG) - 2025
परीा कद के िलए िवकप
.सं. (S.No.) शहर का नाम (राय का नाम) (City Name (State Name))
(Choice For Exam Center)
1 1stChoice For Exam Center Indore ( Madhya Pradesh )
nd
2 2 Choice For Exam Center Ujjain ( Madhya Pradesh )
rd
3 3 Choice For Exam Center Bhopal ( Madhya Pradesh )
th
4 4 Choice For Exam Center Khandwa ( Madhya Pradesh )
िपता/अिभभावक की योयता (Father िपता/अिभभावक का यवसाय
Illiterate Business
/Guardian Qualification) (Father/Guardian Occupation)
माता/अिभभावक योयता (Mother माता/अिभभावक का यवसाय
Others Self-Employment
/Guardian Qualification) (Mother/Guardian Occupation)
टे ट पे पर िववरण (Test Paper Details)
.सं. (S.No.) टे ट पे पर (Test Paper) मयम (Medium)
1. SCQP09-Computer Science / Information Technology NA
I hereby declare that I have chosen and verified the paper codes in the online Application Form for the CUET (PG) - 2025 examination as per the eligibility
criteria of the university/ies in which I intend to seek admission to suitable courses.
I understand that merely appearing in the CUET (PG) - 2025 examination does not make me eligible for admission into any course or university for
admission, I also have to fulfill the other eligibility conditions specified by the respective university/ies.
I take full responsibility for the accuracy of the information provided and understand that any discrepancy or non-compliance with the eligibility criteria may
lead to the rejection of my application or cancellation of my admission at any stage.
I further agree to abide by the rules and regulations of the National Testing Agency (NTA) and the participating universities regarding the CUET (PG) -
2025 examination and the admission process.
योयता िववरण (Qualification Details)
10वीं योयता िववरण (10th Qualification Detail)
उीण वष /उपिथित (Passing of
पास की िथित (Pass Status) Passed 2020
Year/Appearing)
कोस / टीम (Course/Stream) 10th Or Equivalent
बोड /िवविवालय का नाम (Board/University Name) CENTRAL BOARD OF SECONDARY EDUCATION
Narmada Valley
संथान का नाम और पता (Institute
International School Barwaha रोल नंबर (Roll Number) 19159651
Name And Address )
451115
पिरणाम मोड (Result Mode) Percentage कुल अंक (Total Marks) 500.00
ात अंक(Obtained Marks) 319.00 ितशत % (Percentage %) 63.80
12वीं योयता िववरण (12th Qualification Detail)
उीण वष /उपिथित (Passing of
पास की िथित (Pass Status) Passed 2022
Year/Appearing)
कोस / टीम (Course/Stream) 12th Or Equivalent
बोड /िवविवालय का नाम (Board/University Name) CENTRAL BOARD OF SECONDARY EDUCATION
संथान का नाम और पता (Institute K V S CISF Complex
रोल नंबर (Roll Number) 19650780
Name And Address ) Barwaha Khargone MP
पिरणाम मोड (Result Mode) Percentage कुल अंक (Total Marks) 500.00
ात अंक(Obtained Marks) 328.00 ितशत %(Percentage %) 65.60
नातक योयता िववरण (Graduation Qualification Details)
उीण वष /उपिथित (Passing of
पास की िथित (Pass Status) Appearing 2025
Year/Appearing)
कोस / टीम (Course/Stream) BCA
बोड /िवविवालय का नाम (Board/University Name) Devi Ahilya Vishwavidyalaya, Indore
संथान का नाम और पता (Institute I P S Academy School Of
रोल नंबर (Roll Number) 220460540
Name And Address ) Computers
उमीदवार ारा अपलोड की गई छिवयां (Images Upload by Candidate)

PHOTO

SIGNATURE

शु क भु गतान िववरण (Fee Payment Details)

ऑडर आईडी (Order ID) CUETPG_253510096614_1736784754
भु गतान का कार (Payment Mode) Online लेन-दे न आईडी (Transaction ID) CPAERQIQM7
शु क जमा िकया गया (Fee
परीा शु क (Exam Fee) 1400.0 13-01-2025 21:42:34 PM
Submitted On)
शु क की पु िट ितिथ (Fee Confirmed भु गतान गे टवे का नाम (Payment
13-01-2025 21:45:19 PM SBI Epay
Date) Gateway Name)
भु गतान की िथित (payment status) Success
घोषणा (Declaration)
I hereby declare that I have filled up this online application after carefully reading the Bulletin and fully understanding the provision/procedures mentioned
therein. I further declare that all the particulars given by me in this application are true to the best of my knowledge and belief. I agree that my result may be
withheld/not declared/ my candidature may stand cancelled. In case it is found at any point of time in future that false information has been furnished in this
application. I shall abide by these terms and conditions as well as those laid down in the Information Bulletin, Public Notice and Advisories issued by NTA
regarding this exam time to time.
IP Address : 27.59.119.240 Date of Downloading : 13-01-2025 21:45:20 PM
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