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The document is a private enrollment registration form for May 2024 for a B.A. program at Govt Tulsi Degree College, Anuppur, with an application status approved but enrollment number not generated. The applicant, Hawa Shankar Chauhan, has paid a total fee of Rs. 2040 and provided personal and educational details. Important notices regarding data accuracy and submission of the registration form are included.

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48 views2 pages

Ptns

The document is a private enrollment registration form for May 2024 for a B.A. program at Govt Tulsi Degree College, Anuppur, with an application status approved but enrollment number not generated. The applicant, Hawa Shankar Chauhan, has paid a total fee of Rs. 2040 and provided personal and educational details. Important notices regarding data accuracy and submission of the registration form are included.

Uploaded by

shivamgamingr150
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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NEP PRIVATE ENROLLMENT/REGISTRATION FORM MAY-2024

Transaction Details
Application Status: Application is approved by college and University but Enrollm ent num ber is not yet generated.
Application Number
EN25P000302
(Note your App No for future references.)

DONE ON May 6 2025


Payment Status Channel Id K20210211642905
5:04:17:920PM
Payment
Transaction Id 25050617830201702477 KIOSK
Mode
Late
Enrollment Fee(Rs.) 2000 0
Fee(Rs.) QR-Code [Scan to
Verify]
Immigration Fee(Rs.) 0
Portal Fee(Rs.) 40 Total(Rs.) 2040

College & Course Details


College Name :Govt Tulsi Degree College, Anooppur, Anuppur Program Name :B. A. (Private)
Course Group/Branch Name :BA Medium :Hindi

Personal Details
Full Name HAWA SHANKAR CHAUHAN (हवा शंकर चौहान)
Father's Name RAM SURAT CHAUHAN
Photo-Signature
Mother's Name REKHA DEVI
Date of Birth 04/01/1977 (DATE FORMAT: DD/MM/YYYY)
Gender MALE
Marital Status MARRIED
Category UR
Sub-Category -NA-
Religion HINDU
Nationality INDIAN
M.P.Domicile Yes

Personal Details
Correspondence Address
House No/Village WARD NO 09 PWD OFFICE KE PICHE ANUPPUR Colony/Post ANUPPUR
City/Tehsil ANUPPUR State MADHYA PRADESH
District ANUPPUR Pincode 484224

Permanent Address
House No/Village WARD NO 09 PWD OFFICE KE PICHE ANUPPUR Colony/Post ANUPPUR
City/Tehsil ANUPPUR State MADHYA PRADESH
District ANUPPUR Pincode 484224

Contact Details
Mobile Number : XXXXXX-4452 Email Id : ch*********4@gmail.com

Previous Education Details


Exam Passed: HSSC University/ Board: Other Board
Passing Year: 2014 Percentage: 43.2
Previous Roll No 430429 Eligibility/Migration/Transfer Certificate No:

Enclosures
Eligibility certificate? :No Migration certificate? :No Proof for DOB? :Yes
Marksheet? :Yes Gap Certificate? :No Transfer Certificate? :No Handicap? :No

Declaration
Note: I hereby declare that the information filled by me is true and complete as per my knowledge.
Important Notice
(1)छात्र के Basic डाटा विश्वविद्यालय द्वारा प्रदान की गयी डाटा के आधार पर प्रदर्शित की गयी है, एवं अन्य डाटा छात्रों द्वारा स्वयं Update की गयी गई है। अतः डाटा सम्बंधित समस्या के लिए छात्र,
महाविद्यालय अथवा विश्वविद्यालय संपर्क करें। (2) परीक्षा फॉर्म बिना नामांकन संख्या के नहीं भरे जा सकें गे, अतः सभी छात्र Registration Form / Enrollment Form अवश्य भरें, एवं भुगतान करने
के पश्चात् (जिसमें Application no., Transaction Id, Payment date, QR Code आदि का विवरण हो) सम्बंधित महाविद्यालय में जमा करें अन्यथा फॉर्म स्वतः निरस्त हो जायेगा।

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