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Directorate of Teacher Education and State Council of Educational Research and Training

BhubaneshwarADMISSION PROCESS 2014-15

Ve rsi o n No . : 2

Fo rm No . :

9226366

Form No. : 9226366 Photo

Signature

Domicile of Orissa : Yes

Applied Course : D.El.Ed

Name : KUMARI LOPAMUDRA

Father'sName/Husband Name :

NIRANJAN SAHOO

Mother's Name : SANJUKTA SAHOO

Gender : Female Marital Status : Single

Date of Birth : 07/12/1996 Age As on :30/04/2014 17 Years; 4Months; 23 Days

Phone No. : 06742-552118 Mobile No. : 9437229379

Email-Id : [email protected]

:: Address Details ::

Correspondence Address :

N4 102 BHUBANESWAR Block : Khurda Sub-Division : Bhubaneswar District : Khurda State :Odisha Pin : 751015

Permanent Address :

13 JAHANGIRPUR Block : Niali Sub-Division : Cuttack District : Cuttack State : Odisha Pin :754004

:: Reservation Details ::

Social Category : OBC/SEBC

Other Reservation : --

Class 10 Details ::

Name of Board : Board of Secondary Education, Cuttack

Year of Passing : 2012

Aggregate Marks :Maximum Marks Marks Obtained Percentage

600 492 82.00

Class +2 Details ::

Name of Board : Council of Higher Secondary Examination

Year of Passing : 2014 Discipline : Science

Aggregate Marks :Maximum Marks Marks Obtained Percentage

600 326 54.33

Oriya Studying Status : passed HSC Examination of BSE, Odisha in Odia medium with MIL Other than Odia

D.El.Ed. college applied quota General D.El.Ed



:: College Preference Details ::

Filled Options ([preference-Code]) :

[1-1510101] [2-1650101] [3-1680101] [4-1360101] [5-1720101] [6-1840101] [7-1750101][8-1220101] [9-1310101] [10-1270101] [11-1590101] [12-1170101] [13-1180101] [14-1190101] [15-1200101] [16-1210101] [17-1230101] [18-1240101] [19-1250101] [20-1260101] [21-1280101] [22-1290101] [23-1300101] [24-1320101] [25-1330101] [26-1340101] [27-1350101] [28-1370101] [29-1380101] [30-1390101] [31-1400101] [32-1410101] [33-1420101] [34-1430101] [35-1440101] [36-1450101] [37-1460101] [38-1470101] [39-1480101] [40-1490101] [41-1500101] [42-1520101] [43-1530101] [44-1540101] [45-1550101] [46-1560101] [47-1580101] [48-1600101] [49-1610101] [50-1620101] [51-1630101] [52-1640101] [53-1660101] [54-1670101] [55-1690101] [56-1700101] [57-1710101] [58-1730101] [59-1760101] [60-1770101] [61-1780101] [62-1570101] [63-1790101] [64-1800101] [65-1810101]

De cl a ra t i o n :

I hereby declare that all the information furnished by me in this Application Form is true and complete to the best of my knowledge and

belief. I understand that entries made by me in this Application Form are final and binding on me.

Place : Date :Signature of the Candidate

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