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11/22/2018 NEET - PG 2019

Applicant Details

Personal Details
Application Seq No Candidate's Name
PG159507 ANKIT SINGH
Father's Name Mother's Name

Anirudha kumar singh Krishna singh


Nationality Gender

Indian Male
Date of Birth Religion

10/Oct/1990 Hindu

Category Physically Challenged


SC No

Place of Birth ARE YOU WILLING TO TAKE UP POST GRADUATE


COURSES IN ARMED FORCES MEDICAL SERVICES
Auraiya
INSTITUTIONS
Yes

ARMED FORCES MEDICAL SERVICE CATEGORY


Civilians (will have bond liability to serve
AFMS)

Contact Details
Mobile Number Alternate Mobile Number
8400340050 9455851325

Email ID
drankitsingh10@gmail.com

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11/22/2018 NEET - PG 2019

Identification Details
Identification Identification No.
Aadhar Card 734306982514

Marks of Identification
Black mole right arm, 8 cm from right
clavicle

Correspondence Address
Address Line 1

573/460

Address Line 2

Mumfordganj

Country State
INDIA UTTAR PRADESH

City/District Pin Code

Allahabad 201002

Permanent Address
Address Line 1

Village Biruhuni

Country State
INDIA UTTAR PRADESH

City/District Pin Code


Auraiya 206129

Medical Council Registration Details


MCI/SMC REGISTRATION TYPE
Permanent

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11/22/2018 NEET - PG 2019

MCI/SMC REGISTRATION NUMBER

73356

STATE OF REGISTRATION
UTTAR PRADESH

REGISTRATION MEDICAL COUNCIL


Uttar Pradesh Medical Council

Academic Details
State of Completion of Class 10th
UTTAR PRADESH

State of Completion of Class 12th


UTTAR PRADESH

MBBS Details
Country of completion of MBBS Qualification
INDIA

State
UTTAR PRADESH

City University of Completion


Kanpur Nagar DR B R AMBEDKAR UNIVERSITY,AGRA, U.P.

University Name Name of College


Dr. B R Ambedkar University, Agra RAMA MEDICAL COLLEGE AND HOSPITAL ,
KANPUR

Month and Year of Passing


31/03/2015

Internship Details
Have you completed Internship

Yes

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11/22/2018 NEET - PG 2019

Location of Internship

Kanpur

Institute of Internship Date of start of Internship

Rama Medical College And Hospital 01/04/2015

Date of completion of Internship


31/03/2016

MBBS EXAMINATION MARKS


1st MBBS Examination-Percentage of marks obtained

56.33

2nd MBBS Examination-Percentage of marks obtained

58.36

Final MBBS Examination-Percentage of marks obtained


56.23

Additional Information
Deported/Rusticated during Medical Course Charged of use of unfair means by NBE/Other
examination body
No
No

Have you appeared in NEET PG previously


No

Test Center Details


State City

Uttar Pradesh Kanpur

Payment Details
Amount Payment Transaction No
2750 PSBI6919089670

Payment Status

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11/22/2018 NEET - PG 2019

Successful

Candidate Images Upload Details

Photo

Signature

Declaration

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11/22/2018 NEET - PG 2019

NEET PG is a proprietary examination and is conducted by National Board of Examinations. The


contents of this exam are confidential, proprietary and are owned by National Board of Examinations.
NBE explicitly prohibits the candidate from publishing, reproducing or transmitting any or some
contents of this exam, in whole or in part, in any form or by any means verbal or written, electronic or
mechanical or for any purpose. No content of this exam must be shared with friends, acquaintances
or third parties including sharing through online means or via social media. Social media includes but
not limited to SMS, Whatsapp, Facebook, Twitter, Hangouts, Blogs etc using either one’s own account
or proxy account(s). By registering for and /or appearing in NEET PG the candidate explicitly agrees to
the above Non Disclosure Agreement and general terms of use for NEET PG as contained in this
Information Bulletin, and NEET PG website. Violation of any act or breach of the same shall be liable
for penal action and cancellation of the candidature at the bare threshold

I certify that I fulfill the eligibility requirements for NEET PG and have furnished complete and correct
information.
I understand that any instances of furnishing incorrect information detected at any stage of the
selection process will automatically disqualify me from the selection process and I will not be allowed
appear for NEET PG in future.
Similarly, if such instances go undetected during the current selection process but, are detected in
subsequent years, such disqualification will take place with retrospective effect.
I also understand that provision of incomplete information will automatically disqualify me from the
selection process.
I have read the information bulletin and do hereby undertake that I will not indulge in any unfair
means/practice for NEET PG
I understand that the decision of NBE shall be final and binding upon me.
Any dispute concerning NEET PG would be subject to Jurisdiction of the Competent Courts exclusively
at Delhi/New Delhi only.
I will comply with the Non Disclosure Agreement as indicated in the information bulletin. I certify that I
have read and gone through the information bulletin for the exam.

Version 13.05.01

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