Chaudhary Charan Singh University, Meerut

Chaudhary Charan Singh University, Meerut [ Computer Copy ]
Examination Form for Traditional BAMS/MD(Ayurved)/MS(Ayurved)

Regular/Supplementary Examination - 2020
1. Course Name : B.A.M.S. (Ayurvedacharya) IInd Prof.
2. Roll No. : 18010864060 3. Enrolment No. : 1802021
4. College Name : GS AYURVEDA MEDICAL COLLEGE & HOSPITAL, PILKHUWA Form No:210413184
HAPUR
5. Type of Exam : Main Exam
6. Name of the Candidate : PRAJJWAL PRATAP SINGH TOMAR
7. Father`s Name : PUSHPENDRA SINGH
8. Mother`s Name : PARUL
9. Nationality : INDIAN 10. Medium of Exam : HINDI
11. Date of Birth : 15/08/2000 12. Sex : Male
13. Original Resident of : U.P. 14. Kashmiri Migrant : No
15. Caste : General (101)
16. State from where Graduated : UP
17. Do you have Domicile Certificate of U.P. State: Yes Signature of Candidate
18. Permanent Address : H NO 12 GALI NO 7 A/2 BLOCK WEST SANT NAGAR BURARI,
DELHI, NORTH, Pin : 110084
19. Present Address : H NO 12 GALI NO 7 A/2 BLOCK WEST SANT NAGAR BURARI,
20. Phone/Mobile No. : 8851275231
21. Email ID : prajjwalpratapsingh83197@gmail.com
22. Name of Subjects

S.No. Name of the Papers Code No.
1 Dravyaguna Vijnan (Paper-I) 201
2 Dravyaguna Vijnan (Paper-II) 202
3 Rasashastra Evam Bhaishajya Kalpana (Paper-I) 204
4 Rasashastra Evam Bhaishajya Kalpana (Paper-II) 205
5 Charaka Samhita - Purvardha 206
6 ROG-NIDAN (Paper-I) 207
7 ROG-NIDAN (Paper-II) 208
8
23. Description of Examination:

Name of Examination Year Name of the Board/University Subjects Taken Mrks Max.
obt. Mrks
High School 2016 CBSE HINDI ENG MATH SCI SST 340 500
Intermediate 2018 CBSE PHY CHE BIO ENG PHY EDU 325 500
Graduation (BAMS) CCS UNIVERSITY
Post Graduation()
Page 1/4
Course : B.A.M.S. (Ayurvedacharya) IInd Prof.
Type of Exam : Main Exam From No. : 210413184
24. Give details of marks obtained in previous examination Result

Part Roll No. Year Result Obtained Marks Maximum Marks
1 18010864060 2018-19 PASS 593 1050
25. Detail of punishment for U.F.M. if any, imposed in any previous examination :
Name of the Class : Punishment Details :
Roll No : Year : Name of Centre :
26. If last examination passed from other university give the details of migration certificate from that university :
27. If you are employed , give the details of "No Objection Certificate" :
28. Whether Doing Ph.D. or any other degree of any other University in India/Abroad, you may state full particulars :
29. If Migration certificate is enclosed from another university/Board. mention its no. & date :
30. Participation in Sports:- Level of Game/Sports :
31. Checklist (Attached Documents)

Marksheet of High School : Yes Marksheet of Intermediate : Yes Marksheet of Graduation : No
Marksheet of Post Graduation : No Residence/Domicile Certificate : Yes Handicap Certificate : No
Caste Certificate :No Migration Certificate : No No objection certificate : No
Any other certificate 1. 2.

Declaration
I PRAJJWAL PRATAP SINGH TOMAR(210413184), S/o PUSHPENDRA SINGH hereby declare that the information given in the
application form is true to the best of my knowledge and belief. In case any information is found false / untrue, cancel my admission /
exam form, for which no claim of refund of fee would be raised by me, in future also, if any particular submitted are found to be untrue
/ false, the university can cancel my degree.
Detail of Examination Fee

Transaction No. : 70002024766 Total Fees : 3854
Date : 26/04/2021 Payment Status : PAID
Date:___________________
Place:___________________ (Full Signature of the Applicant)
Certificate of the Principal

PRAJJWAL PRATAP SINGH TOMAR, S/o PUSHPENDRA SINGH has been registered for Regular examination. All the entries in the
exam from, marksheets and other certificates attached have been duly checked and this is certified that he/she is eligible for
examination as per university rule and his/her examination form is being forworded.
Date:___________________
Sign of the checker :___________________ (Full Signature of the Principal with stamp)
Page 2/4
Chaudhary Charan Singh University, Meerut [ University Copy ]
Examination Form for Traditional BAMS/MD(Ayurved)/MS(Ayurved)
Regular/Supplementary Examination - 2020
1. Course Name : B.A.M.S. (Ayurvedacharya) IInd Prof.
2. Roll No. : 18010864060 3. Enrolment No. : 1802021
4. College Name : GS AYURVEDA MEDICAL COLLEGE & HOSPITAL, PILKHUWA Form No:210413184
HAPUR
5. Type of Exam : Main Exam
6. Name of the Candidate : PRAJJWAL PRATAP SINGH TOMAR
7. Father`s Name : PUSHPENDRA SINGH
8. Mother`s Name : PARUL
9. Nationality : INDIAN 10. Medium of Exam : HINDI
11. Date of Birth : 15/08/2000 12. Sex : Male
13. Original Resident of : U.P. 14. Kashmiri Migrant : No
15. Caste : General (101)
16. State from where Graduated : UP
17. Do you have Domicile Certificate of U.P. State: Yes Signature of Candidate
18. Permanent Address : H NO 12 GALI NO 7 A/2 BLOCK WEST SANT NAGAR BURARI,
19. Present Address : H NO 12 GALI NO 7 A/2 BLOCK WEST SANT NAGAR BURARI,
20. Phone/Mobile No. : 8851275231
21. Email ID : prajjwalpratapsingh83197@gmail.com
22. Name of Subjects

S.No. Name of the Papers Code No.
1 Dravyaguna Vijnan (Paper-I) 201
2 Dravyaguna Vijnan (Paper-II) 202
3 Rasashastra Evam Bhaishajya Kalpana (Paper-I) 204
4 Rasashastra Evam Bhaishajya Kalpana (Paper-II) 205
5 Charaka Samhita - Purvardha 206
6 ROG-NIDAN (Paper-I) 207
7 ROG-NIDAN (Paper-II) 208
8
23. Description of Examination:

Name of Examination Year Name of the Board/University Subjects Taken Mrks Max.
obt. Mrks
High School 2016 CBSE HINDI ENG MATH SCI SST 340 500
Intermediate 2018 CBSE PHY CHE BIO ENG PHY EDU 325 500
Graduation (BAMS) CCS UNIVERSITY
Post Graduation()
Page 3/4
Course : B.A.M.S. (Ayurvedacharya) IInd Prof.
Type of Exam : Main Exam From No. : 210413184
24. Give details of marks obtained in previous examination Result

Part Roll No. Year Result Obtained Marks Maximum Marks
1 18010864060 2018-19 PASS 593 1050
25. Detail of punishment for U.F.M. if any, imposed in any previous examination :
Name of the Class : Punishment Details :
Roll No : Year : Name of Centre :
26. If last examination passed from other university give the details of migration certificate from that university :
27. If you are employed , give the details of "No Objection Certificate" :
28. Whether Doing Ph.D. or any other degree of any other University in India/Abroad, you may state full particulars :
29. If Migration certificate is enclosed from another university/Board. mention its no. & date :
30. Participation in Sports:- Level of Game/Sports :
31. Checklist (Attached Documents)

Marksheet of High School : Yes Marksheet of Intermediate : Yes Marksheet of Graduation : No
Marksheet of Post Graduation : No Residence/Domicile Certificate : Yes Handicap Certificate : No
Caste Certificate :No Migration Certificate : No No objection certificate : No
Any other certificate 1. 2.

Declaration
I PRAJJWAL PRATAP SINGH TOMAR(210413184), S/o PUSHPENDRA SINGH hereby declare that the information given in the
application form is true to the best of my knowledge and belief. In case any information is found false / untrue, cancel my admission /
exam form, for which no claim of refund of fee would be raised by me, in future also, if any particular submitted are found to be untrue
/ false, the university can cancel my degree.
Detail of Examination Fee

Transaction No. : 70002024766 Total Fees : 3854
Date : 26/04/2021 Payment Status : PAID
Date:___________________
Place:___________________ (Full Signature of the Applicant)
Certificate of the Principal

PRAJJWAL PRATAP SINGH TOMAR, S/o PUSHPENDRA SINGH has been registered for Regular examination. All the entries in the
exam from, marksheets and other certificates attached have been duly checked and this is certified that he/she is eligible for
examination as per university rule and his/her examination form is being forworded.
Date:___________________
Sign of the checker :___________________ (Full Signature of the Principal with stamp)
Page 4/4

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Chaudhary Charan Singh University, Meerut [ Computer Copy ]

Examination Form for Traditional BAMS/MD(Ayurved)/MS(Ayurved)

22. Name of Subjects

23. Description of Examination:

24. Give details of marks obtained in previous examination Result

30. Participation in Sports:- Level of Game/Sports :

31. Checklist (Attached Documents)

Any other certificate 1. 2.

Detail of Examination Fee

Certificate of the Principal

22. Name of Subjects

23. Description of Examination:

24. Give details of marks obtained in previous examination Result

30. Participation in Sports:- Level of Game/Sports :

31. Checklist (Attached Documents)

Any other certificate 1. 2.

Detail of Examination Fee

Certificate of the Principal

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