Mar 23, 2017
selvisenthil's response CENTRAL BOARD OF SECONDARY EDUCATION
CONFIRMATION PAGE - NEET(UG)-2017
You have successfully submitted On-line Application. Please preserve this page along with proof of fee payment for future
reference.
Application / Registration No. : 80865791
Candidate's Name MAHALAKSHMI
VIJAYAKUMAR
Date of Birth 18/03/2000
Mother's Name SHEELA V Gender Female
Father's Name R VIJAYAKUMAR Category OBC
Year of Passing/Appearing Class
XII
2017 Status of Locomotor Disability of
Lower Limbs
No
State/Country to which Applicant
belongs
Tamil Nadu Nationality Indian
Question Paper Medium English Class XII Marks(%) -
Mobile No. 91-[protected] Email Id [protected]@gmail.co
m
Choice of Exam Centres TIRUCHIRAPALLI (
970)
MADURAI ( 968) CHENNAI ( 966)
DECLARATION :- I hereby solemnly and sincerely affirm that all the particulars stated by me in the Application Form are
true and correct. Even the spelling of names and category is correct. I have not concealed any information including
information about previous attempts in AIPMT/NEET. However, if any information furnished herein is found fraudulent,
incorrect or untrue, I understand that I will be liable for criminal prosecution which will result incancellation of my
candidature. Further that the selection and admission to the course is liable to be cancelled. I agree to abide by the
Rules and Regulations governing the Examination as contained in the Information Bulletin for NEET, 2017 which I have
gone through carefully. I further declare that I have not submitted any other application for NEET, 2017 and mobile no
and email address given in the form are correct and my own or of my parents.
Photo Signature
Complete Mailing Address
Address 197, TRICHY AIRPORT, ANNAI ASIRAMAM
City CITY
State/Country Tamil Nadu Pin Code 620007
Details of Transaction(ICICI Bank)
Transaction ID.:[protected] Total Amount: 1400 Date of Transaction: 2/21/2017 3:33:10 PM
Card Type : VISA/Master Card
Registration No: 80865791 Printed On : 21/02/2017
please do share your grievances. They are more effective and monitered from high level hierarchy.
If you do so, it will directly affect their performance and question by higher authorities.