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Joint Entrance Examination (Advanced) 2019

Indian Institutes of Technology


REGISTRATION RECEIPT

Registration No. R214201907


Do not send any hard copy of this Registration Receipt to to your Zonal IIT (Preserve this page for future correspondence)
This document is not a substitute for your Admit Card. You will be able to download the Admit Card from 10 A.M. of May 20, 2019 till 9 A.M. of May 27, 2019.
Candidate Details
JEE (Main) Application 190310037190 Date of Birth 02/01/2003
No.
Candidate's Name ATUL KUMAR Category OBC- NCL (CENTRAL LIST)
Mother's Name MAMTA DEVI Person with Disability (PwD) NO
Father's Name SANTOSH KUMAR KHATRI Nationality INDIAN
Complete Mailing Address
Address KARA
Country India
State BIHAR District AURANGABAD
Locality KARA Mobile Number 799****313
City/Town/Village AURANGABAD Email Address atu***********@gmail.com
Pin Code / Postal Code 824124 Additional Mobile No 989****378
Land Line Number 989****378 Additional Email Address San**************@gmail.com
Academic details of Class XII (or equivalent) examination
Year of Passing or Appearing 2019
Name of the Class XII (or equivalent) examination THE FINAL EXAMINATION OF THE 10+2 SYSTEM, CONDUCTED BY ANY RECOGNIZED CENTRAL/ STATE
BOARD, SUCH AS CENTRAL BOARD OF SECONDARY EDUCATION, NEW DELHI; COUNCIL FOR THE INDIAN
SCHOOL CERTIFICATE EXAMINATIONS, NEW DELHI; ETC.
School Board BIHAR INTERMEDIATE EDUCATION COUNCIL (BIHAR SCHOOL EXAMINATION BOARD)
Roll Number 19010030
Name of the School / College J P HIGH SCHOOL
Address of the School / College DHARAMPURA,BARUN
JEE (Main) Paper 1 Score
Physics: 96.6995364 Chemistry: 91.3827360 Maths: 98.5907719 Total: 97.6589521
Remarks : Eligible for JEE (Advanced) 2019
Furnished Information for JEE (Advanced)
Guardian's Name SANTOSH KUMAR KHATRI Need scribe/reader NOT APPLICABLE
Year of First attempt in JEE (Advanced) 2019 Color Blindness No
One Eyed Vision No Eligible for DS Seats NO
Examination City for JEE (Advanced)
1st Choice of Exam City RAJASTHAN-JAIPUR 2nd Choice of Exam City RAJASTHAN-AJMER
3rd Choice of Exam City DELHI NCR-DELHI (NORTH) 4th Choice of Exam City DELHI NCR-DELHI (SOUTH)
5th Choice of Exam City DELHI NCR-DELHI (EAST) 6th Choice of Exam City DELHI NCR-DELHI (WEST)
OBC-NCL Certificate details
Do you have a Valid OBC-NCL I have not been able to collect the said State / UT issuing the OBC Certificate BIHAR
Certificate? certificate as of now. I will upload the
Declaration in Lieu of OBC-NCL Certificate.
OBC-NCL certificate will be uploaded on
or before June 5, 2019).
OBC Caste / Community Sonar, Sunar
Entry No. of OBC Caste / Community 117
Payment Details
Payment Mode Debit Card Transaction ID CPS0168117
Registration Fee 2600 ( INR ) Date of Transaction 06-05-2019 16:33:38
DECLARATION
I hereby declare that all the particulars stated in this Registration Reciept are true to the best of my knowledge and belief. I have read and understood the JEE (Advanced)
procedures. I shall abide by the terms and conditions therein. I understand that, if any of the information provided by me is found to be false / incorrect at any later time, my
candidature shall be cancelled and I shall be debarred from appearing for JEE (Advanced).
Images Uploaded by Candidate (During JEE (Main) Registration)

Certificates uploaded
Class X or Birth Certificate Uploaded Class XII (or equivalent) Certificate Not Applicable
OBC-NCL Certificate Uploaded Additional OBC- NCL (CENTRAL LIST) Not Applicable
Certificate
PwD Certificate Not Applicable Scribe Request Letter Not Applicable
DS Certificate Not Applicable PIO Card / OCI Card Not Applicable

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