GOVERNMENT OF GUJARAT Submit Date : 18/08/2025
Application No:
PM -YASASVI Post Matric Scholarship for OBC, EBC and DNT 252600000000397877
Students
Renewal Application
Previous Application No: 242500000001907843
Previous Paid Scholarship:
Student Basic Details
Name of Student : patel bhavaniben Miteshbhai
Name of Student (As per Aadhar) : patel bhavaniben miteshbhai
Date of Birth : 05/12/2002 Gender : Female
Student Aadhar Details
I voluntarily give my consent to use my Aadhaar details.
Aadhar No : 45xxxxxx9712 Aadhaar Status Verified: Yes(18/08/2025 15:12:27)
Student Ration Card Details
Consent Status: I hereby give my consent to use my personal data available with food and civil supply department. I hereby give my consent to
government of Gujarat for fetching my identity for the purpose of post matric scholarship.
Ration Card No. : 121002002569572 Ration Card Member No. : 121002002569572006
Name As Per Ration Card: (Patel Bhavaniben Miteshbhai / XN°_[ahWjZpW
\jSpc[h:
EKYC Status As Per Ration Card: Yes EKYC Date: 02-12-2024
Aadhar Number Matched With Ration Card: Yes
Student OTR Details
OTR KYC : OTR KYC :
Name as Per OTR :
Other Details
Mother's Name : patel varshaben miteshbhai
Category : EBC(8iTD^SpXJhSaF½ Religion :Hindu
Caste : linguistic Minority :
Marital Status : Unmarried Parent/Guardian occupation: Business(V5Vs
Annual Income of Parents/Guardian/Husband (Rs): 150000 Habitation Type: Urban
Is Orphan: NO
Mobile Number : 9313309466 E-mail Address : bhavanimitesh0@gmail.com
Day Scholar / Hosteller: Day Scholar
Hostel Type:
Current Address: Permanant Address:
State Gujarat State Gujarat
District Vadodara District Vadodara
Taluka Karjan Taluka Karjan
Village Village
PinCode 391240 PinCode 391240
Address:31 akruti bunglow nava bazar karjan Address:31 akruti bunglow nava bazar karjan
Student Bank Account Detail/Aadhar Bank Detail
Aadhar Number : - Bank name : -
NPCI Date : NPCI Status : -
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Page 1 of 3 252600000000397877 Print Date :20/08/2025
Account No : 26xxxxxx0788 IFSC Code : BKID0002609
Student Name(As per Bank Name): patel bhavaniben miteshbhai
Name of Bank : BANK OF INDIA
Branch Name & Address : KARJAN
I hereby accept that
1.Details provided by me are correct to best of my knowledge
2.Shall not make any claims if amount is transferred to a wrong account due to incorrect details provided by me
3.Shall refund the amount transferred to someone else¶s account due to incorrect details provided by me
4.I will refund the excess amount credited to my account, if any.
Student Academic Details
Admission Type : Regular Paid Seat (Self Finance)
Present Course/Class/Trade Type: Pharmacy
Present Course/Class/Trade Name : M.Pharm Master Of Pharmacy
Present Course/Class/Trade Year : 1ST YEAR(1st Semester/2nd Semester)
Studying in : Gujarat Enrollment No: 242740820007
Present Institute District : Bharuch Present Institute :
LAXMINARAYAN DEV COLLEGE OF
PHARMACY, BHOLAV, BHARUCH 274
Present Branch Course : Pharmaceutics
Enter Your Research/Thesis Subject :
Present Class Start Date : 20-Aug-2024 Present Course Completion Date : 31-Mar-2025
Fees Amount
Admission Fees (Rs) 10000
Tution Fees (Rs) 82688
Misc.Fee(NonRefundable Fees) 250
Exam Fees(Rs) 1000
Total (Rs) 93938
Educational Break : No No. Of. Year in Break :
Previous Education Detail
Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH D C chavda girls B2114571 2018 69
high school
11th Std/12 Std 12TH Shah nbs high B119078 2020 58
school
Pharmacy B.Pharm Bachelor of Pharmacy Laxminarayandev 20274029 2024 7.52
college of pharmacy 0060
Pharmacy M.Pharm Master Of Pharmacy Laxminarayandev 24274082 2025 7.77
college of pharmacy 0007
Disablity Detail
Is Disability : No Type of Disability : -
Percentage of disability : - Required Guide/Coaching Guide: No
Guide Name: -
Guide Address: -
List of documents which you have attached :
1 Caste Certificate From the Competent Authorities
2 First Page Of Bank PassBook/Cancelled Cheque
3 Fee Receipt of Current Course Year
4 Self Attested Certificate of Previous academic marksheet
5 Income Certificate (Competent Authority)(Form no.16 required For Govt. Employee)
Page 2 of 3 252600000000397877 Print Date :20/08/2025
6 School Leaving Certificate (If Any)
I have read all above terms and conditions and understand them fully, I hereby declared that here I am submitting only one
application for scholarship and I haven¶t received any other scholarship/stipend or fellowship in this current session under any other
central/state government scheme. I further state that all information furnished by me is correct to my knowledge in case of any the
false information or suppression of necessary data proved in my application is liable to get cancelled at any stage of the scholarship
process and the entire amount of scholarship will be refunded by me or recovered from me. Government decision shall be final and
binding on me.
Date : 20/08/2025
Verify Mobile Number : Yes 18/08/2025
Place : Signature of the applicant
It is certified that the information filled in the above mentioned fields by the students are correct to the best of my knowledge and
all the Documents has been checked.
It is also certified that in case the applicant leaves institution or otherwise discontinues the studies or detained or accepts any other
regular scholarships/stipend/ fellowship the fact will be immediately reported to the said authority
Certified that the student is eligible for scholarship amount subject to Central/State government rules and the student is
recommended for sanction of scholarship.
This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2025
-2026. If student will irregular, than we will immediately reported to the said authority.
The actual School/College/University year began on __________________ and will be ended on _____________________
Signature Of Head Of The School/College/Institute/University With Official Seal
Place :
*Note : Stamp Signature will not be accepted
Date :
Page 3 of 3 252600000000397877 Print Date :20/08/2025
