Admission Form Annexures For State Quota 2

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RAJASTHAN UNIVERSITY OF VETERINARY AND ANIMAL SCIENCES, BIKANER

Admission Form- B.V. Sc. & A.H. Degree Course (Academic session 2024-25)

SEAT CATEGORY- REGULAR / PAYMENT COUNSELLING ROUND: 1st /2nd /Offline Round
COUNSELLING DATE………………………

Candidate’s Name (In Block letters)-…………………………………..………………………………………………..


Paste same colour
Father’s name (In Block letters)- ………………………………………………………………………………………… photo as uploaded in
online counselling
Mother’s name (In Block letters)- ……………………………………………………………………………………….. Registration form

Gender- Male / Female P.H. category- Yes/No Wards of Defence - Yes/No

Date of Birth ………/………/…………… Age on 31-12-2024- (Days)………. (Months)……….. (Years) ……………


(Minimum age for all categories – 17 years

Category-UR/EWS/OBC/MBC/SC/ ST/STA Caste - …………………….. Religion ……………………

Domicile State………………………… Aadhaar Card No…………………………………………..

BVSc & AH-2024 Counselling Reg No. ……………………………… NEET(UG)-2024 Application No.…………………………

NEET (UG)-2024 Roll No.………………………………… NEET(UG)-2024 Score ……………………..

Occupation of father (Govt./Private/Others) Occupation of Mother (Govt./Private/Others)


Only OBC Non-creamy layer candidates must mention annual income of Father & Mother and attach income certificate separately for financial year 2022-23.

Annual Income of Father (2023-24). Rs. ……………………… Annual Income of Mother (2023-24). Rs. ……………………

(For Office Use Only)

Original Documents Produced [✓] Not produced [] Not applicable [N.A.]
1. Aadhar Card (Self attested photocopy)
2. Rajasthan Domicile Certificate
3. Caste Certificate with issue date (as applicable)
4. NEET(UG)-2024 Online Application Form
5. NEET(UG)-2024 Admit Card
6. NEET(UG)-2024 Score Card
7. Online Registration Form for Counselling along with college preferences
8. Disability Certificate from Physically handicapped candidates (if applicable)
9. Priority Certificate from Wards of Defence/Paramilitary persons (if applicable)
10. Secondary Examination Marks Sheet & Certificate
11. 11th Class Mark Sheet
12. Senior Secondary Examination Marks Sheet & Certificate
13. Character Certificate from Principal of last attended Institute
14. T.C. of last attended Institute
15. Migration Certificate (if applicable)
16. Annexure -1 (Physical Fitness Certificate)
17. Annexure -2 (Self attested declaration)
18. Annexure -3 (Anti ragging certificate)

Signature & complete name of the


document checking officer
Address for Correspondence ………………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………..Village …………………………………………

PO: ………………………….Tehsil:…………………… Distt.:………………………………. State:………….……………PIN Code:………………

Mobile. No. of candidate….………………….. Mobile No. of Parent- ……………………… Email ID- ………………………………….

• Educational Qualification

Year of % of
Name of the Education Board
Name of Examination Passed Passing Marks
Secondary/ Equivalent Recognized Exam.
Name of School-
11th Class

Sr. Sec. / Equivalent Recognized Exam. (with


Physics, Chemistry, Biology/ Biotechnology)

• Marks obtained in Senior Secondary (10+2) or its equivalent recognized examination:-


Max. Marks Marks obtained Percentage of Marks obtained in
Physics, Chemistry,
Name of Subjects Total Biology/Biotechnology & English
Theory Practical Theory Practical
in Senior Secondary or its
equivalent examination
Physics 70 30
Chemistry 70 30 Max. Marks __________

Biology/Biotechnology 70 30 Marks Obtained __________

English 100 – – Percentage __________ Per cent


Grand Total
Aggregate marks percentage (Physics, Chemistry, Biology/Biotechnology & English) General Category – 50%
& all other categories – 47.5%

DECLARATION
I hereby declare that the information furnished by me in this admission proforma is true to best of my
knowledge and belief. In the event of suppression or distortion of any fact, I understand that my
admission/degree acquired is liable to be cancelled for which I shall solely be responsible.

Complete Signature of the candidate

(For Office use only)


Allotted College & Category: ……………………………………………………………………………………………………………….

………………… ………………… ………………… ………………… …………………


(Chairman) (Member) (Member) (Member) (Member)
UG Admission Board UG Admission Board UG Admission Board UG Admission Board UG Admission Board

Fee deposition detail


Book No. Receipt No. Deposit Date Amount (Rs.)
…………………... …………………… ……./….…/…….……. …………………….
…………………… …………………… ….…/….…/….………. …………………….
…………………… …………………… ….…/….…/….………. …………………….
Annexure-1

PHYSICAL FITNESS CERTIFICATE


Candidate
Date: ………………………… Coloured
Photo

I do certify that I have examined (Mr./Miss.) …………………………………………………………………………………………

Son/Daughter of Shri ………………………………………… age about …………………years, who is a candidate for

admission in the B.V. Sc. & A.H. Degree Course in the Rajasthan University of Veterinary and Animal

Sciences, Bikaner and cannot discover any disease, constitutional affection or bodily infirmity

communicable or otherwise, except. ………………………………………………………………………………………………

I further certify the following as per medical Examination of the said candidate:-

1. Height……………………… cms
2. Weight…………………….. kg.
3. Vision : R.E. L.E. with Glasses R.E. L.E.
Distant :
Near :
4. Colour blindness- Present/Absent
Note: Visually handicapped Candidate and the candidate having hearing disability is not Fit
for admission to B.V. Sc. & A.H. Degree Course.
On medical examination, the candidate is found Fit / Unfit for admission to B.V. Sc. & A.H. Degree
Course.

Signature of the Candidate


Place of Examination………………………………..
Date
Signature & Seal of the Medical Jurist
of the Govt. Hospital
Annexure-2

(Self Attested)
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Annexure-3

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