Admission/Enrollment Form Receipt https://mpmsu.mponline.gov.in/Portal/Services/MPMSU/Admission/Pa...

Admission/Enrollment Form 2021-2022

Receipt
Transaction Details

Application Status: Application is pending for payment.

Application Number:
(Please carefully note your M24PP019000067
application No for future
reference.)

Payment Mode: NA

Channel Id: NA

Transaction Id: Not Generated Payment Status: Not Done

Application Fee(Rs.): ₹ 700 Late Fee(Rs.) ₹0

Portal Fee(Rs.): ₹ 100 Total(Rs) ₹ 800

College & Course Details

Admission receipt
Admission receipt No. 68 29/06/2022
Date

Admission Year 2021-2022

College Name VIVEKANAND PARAMEDICAL COLLEGE BHIND, BHIND

Course Type Diploma

DIPLOMA IN MEDICAL LAB.

Course Name Branch MEDICAL LAB. TECHNICIAN
TECHNICIAN

Medium HINDI Admission Type REGULAR

Personal Details

Full Name POOJA GEHLOT (पूजा गहलोत) P h o t o Si g n a t u r e

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Father's Name JOGARAM

Mother's Name LALITA DEVI

Date of Birth 01/01/2003 (DATE FORMAT: DD/MM/YYYY)

Gender Female

Marital Status UNMARRIED

Husband's Name NA Category SC

Nationality INDIAN Religion HINDU

Sub-Category NA MP Domicile No

Contact Details

Correspondence Address
Permanent Address
House No/
00 House No/
Village 00
Village
Colony/Post GWALIOR ROAD
Colony/Post NEW RAM DEV COLONY
MADHYA
City/Tehsil BHIND State City/Tehsil JALOR State RAJASTHAN
PRADESH
District JALOR Pincode 343001
District BHIND Pincode. 477001

Phone No

Mobile Number ******9840

Email Id **********@yahoo.in

Previous Education Details

Exam Passed/Appeared HSSC(12th)

University/Board Other Board-RAJASTHAN BOARD

Passed/Appeared Year 2020 Percentage 61.80

Eligibility/Migration/
HSSC(12th)/NEET
Transfer Certificate 2604234
Roll No :
No.:

12th(PCB) Percentage-57.66

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U p lo a d D o c u m e n t / A t t a c h m e n t

Attached/Required documents scan copy in pdf

Please Click To See Attachment
format

E n clo s u r e s

DME/Ayush Allotment Marksheet? Gap Certificate?

Migration certificate? :Yes Proof for DOB? :Yes
Letter? :No :Yes :Yes

D e cl a r a t i o n

I hereby declare that the information filled by me is true and complete as per my knowledge. If any
information provided by me is found false or incorrect then i shall be disqualified by the university.

No t e

The facility of online form filling and payment of fees is provided directly to the students. Therefore, the
students themselves fill the form and pay the fee. The student will be responsible for the payment made to
another person or internet cafe. This online application will be valid when it has been paid online, in which the
details of application number, QRcode, Transaction Id, Payment date, Channel Id, etc. are clearly stated,
otherwise the application will be automatically cancelled.

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