Government of Bihar
Bihar Combined Entrance Competitive Examination Board
Online Application Form for attending Counselling for admission to first Year Degree Course in Bihar State Medical / Dental /
Ayurvedic / Homoeopathic / Tibbi Colleges for the session 2018 on the basis of NEET(UG)-2018.
The entries below regarding personal details must be same as uploaded in the online submitted application form of NEET(UG)-2018.
UGMAC ID Please don't send this Hard Copy to BCECE Board ALL INDIA NEET RANK
7180005955 48547
PART A
[Link](UG)-2018 Reg. No.: 40523863
[Link](UG)-2018 Roll No.: 502606839
3. Name of Candidate: AASHISH RANJAN
4. Father’s Name: JITESH PRASAD
5. Date of Birth: 14 / SEPTEMBER / 1999
[Link]: MALE
[Link] Category: EBC (EXTREMELY BACKWARD CASTE)
[Link] Quota: NO
[Link] No.: 7678517738
[Link] ID: Ranjanaashish018@[Link]
[Link] of identification: MOLE ON BACK OF NECK
Note : Please Affix your same photo and put your full signature in
[Link] No.: N/A English and Hindi in spaces provided above.
[Link] You Permanent Resident of Bihar?: YES
[Link] Eligibility:
[Link] Name of the Institute of Passing/ Appearing : OTHER
[Link] you claim for Minority Seat in Private Medical/Dental Colleges of Bihar?: NO
[Link] of Minority: N/A
[Link] you passed matriculation with URDU as a subject?: NO
[Link] Details:
Payment Mode Journal No./ Transaction No. Deposit Date Amount (in Rs.)
ONLINE UGMAC5b30aef21353b 2018-06-25 [Link] Rs. One Thousand Two Hundred
[Link] Details:
A. PERMANENT ADDRESS : B. CORRESPONDENCE ADDRESS :
AASHISH RANJAN S\O JITESH PRASAD VILLAGE NEORA AASHISH RANJAN S\O JITESH PRASAD VILLAGE NEORA
NEORA NEORA
BIHTA BIHTA
DISTRICT: PATNA DISTRICT: PATNA
STATE: BIHAR PIN CODE : 801113 STATE : BIHAR PIN CODE : 801113
[Link] Details:
Level School/ College Name Board/ University Name Passing Status Passing Year
Central Board of Secondary
Secondary / Standard X DAV Jasola Vihar Passed 2015
Education
Central Board of Secondary
[Link]. /XII (10+2) DAV Jasola Vihar Passed 2017
Education
Subject English Physics Chemistry Biology
Marks Obtained 87 91 95 92
Full Marks 100 100 100 100
Declaration by the Candidates : I AASHISH RANJAN declare that information furnished above are correct and I shall forfeit my candidature
and will be liable for legal action in case of any of them is proved to be false at any stage inclusive of admission or thereafter.
Date : ..........................
Place : .......................... (Signature in English) (Signature in Hindi)
UGMAC ID :7180005955 Printed On: 25-06-2018 [Link] Page: 1/1
Government of Bihar
Bihar Combined Entrance Competitive Examination Board
Online Application Form for attending Counselling for admission to first Year Degree Course in Bihar State Medical / Dental /
Ayurvedic / Homoeopathic / Tibbi Colleges for the session 2018 on the basis of NEET(UG)-2018.
The entries below regarding personal details must be same as uploaded in the online submitted application form of NEET(UG)-2018.
UGMAC ID Please don't send this Hard Copy to BCECE Board ALL INDIA NEET RANK
7180005955 48547
PART B
(For Office use only)
UGMAC ID: 7180005955 NEET(UG)-2018 Reg. No.: 40523863 NEET(UG)-2018 Roll No.: 502606839 Category:EBC
Selected for Admission(First Counselling) Selected for Admission(Second Counselling) Selected for Admission(Third Counselling)
Against NEET(UG)-2018 Roll No. ....................... Against NEET(UG)-2018 Roll No. ....................... Against NEET(UG)-2018 Roll No. .......................
Category ................................................................ Category ................................................................ Category ................................................................
Merit Serial ............................................................ Merit Serial ............................................................ Merit Serial ............................................................
at ........................................................(institution) at ........................................................(institution) at ........................................................(institution)
in ...............................................(Course/ Branch) in ...............................................(Course/ Branch) in ...............................................(Course/ Branch)
Signature of Signature of the Signature of Signature of the Signature of Signature of the
Controller of Controller of Controller of
the Candidate Verifying the Candidate Verifying the Candidate Verifying
Examination Examination Examination
(At the time of Officer (At the time of Officer (At the time of Officer
BCECEB BCECEB BCECEB
Counselling) UGMAC-2018 Counselling) UGMAC-2018 Counselling) UGMAC-2018
Date : ...................... Date : ...................... Date : ......................
PART B
[Link](UG)-2018 Reg. No.: 40523863
[Link](UG)-2018 Roll No.: 502606839
3. Name of Candidate: AASHISH RANJAN
4. Father’s Name: JITESH PRASAD
5. Date of Birth: 14 / SEPTEMBER / 1999
[Link]: MALE
[Link] Category: EBC (EXTREMELY BACKWARD CASTE)
[Link] Quota: NO
[Link] No.: 7678517738
[Link] ID: Ranjanaashish018@[Link]
[Link] of identification: MOLE ON BACK OF NECK
Note : Please Affix your same photo and put your full signature in
[Link] No.: N/A English and Hindi in spaces provided above.
[Link] You Permanent Resident of Bihar?: YES
[Link] Eligibility:
[Link] Name of the Institute of Passing/ Appearing : OTHER
[Link] you claim for Minority Seat in Private Medical/Dental Colleges of Bihar?: NO
[Link] of Minority: N/A
[Link] you passed matriculation with URDU as a subject?: NO
[Link] Details:
Payment Mode Journal No./ Transaction No. Deposit Date Amount (in Rs.)
ONLINE UGMAC5b30aef21353b 2018-06-25 [Link] Rs. One Thousand Two Hundred
UGMAC ID :7180005955 Printed On: 25-06-2018 [Link] Page: 1/4
[Link] Details:
A. PERMANENT ADDRESS : B. CORRESPONDENCE ADDRESS :
AASHISH RANJAN S\O JITESH PRASAD VILLAGE NEORA AASHISH RANJAN S\O JITESH PRASAD VILLAGE NEORA
NEORA NEORA
BIHTA BIHTA
DISTRICT: PATNA DISTRICT: PATNA
STATE: BIHAR PIN CODE : 801113 STATE : BIHAR PIN CODE : 801113
[Link] Details:
Level School/ College Name Board/ University Name Passing Status Passing Year
Central Board of Secondary
Secondary / Standard X DAV Jasola Vihar Passed 2015
Education
Central Board of Secondary
[Link]. /XII (10+2) DAV Jasola Vihar Passed 2017
Education
Subject English Physics Chemistry Biology
Marks Obtained 87 91 95 92
Full Marks 100 100 100 100
22. Declaration by the Candidates :
I AASHISH RANJAN Son/Daughter of JITESH PRASAD hereby solemnly and sincerely affirm the statements made and information
furnished above by me and in the enclosures hereby submitted by me are true and correct. I have not kept my information secret. If, however, it is
found that any information furnished therein is fraudulent, incorrect or untrue in materials/particulars, I realize that I am liable to criminal
prosecution and agree to forego my seat in the college and further that the selection and admission to this course is liable to be cancelled. I agree
to abide by the rules and regulations governing this counselling.
Repeat bellow in your handwriting (not in capital letters) the above mentioned Declaration and put your signature in English and Hindi at the
specified spaces as signed in Part A of the Online Application forms. If you fail to do so, your Candidature shall be rejected.
Place : .......................... Full Signature in Hindi....................................................................................
Date : .......................... Full Signature in English.................................................................................
Counter signature of the Father/Mother/Guardian
[Link] of Enclosure:
1. ................................................................................................ 2. ................................................................................................
3. ................................................................................................ 4. ................................................................................................
5. ................................................................................................ 6. ................................................................................................
7. ................................................................................................ 8. ................................................................................................
UGMAC ID :7180005955 Printed On: 25-06-2018 [Link] Page: 2/4
24. (AT THE TIME OF FIRST COUNSELLING/ INTERVIEW ONLY)
(i). Full Signature of the Candidate (English)......................................... (ii). L.T.I of the Candidate
(Hindi)............................................
(AT THE TIME OF SECOND COUNSELLING/ INTERVIEW ONLY)
(i). Full Signature of the Candidate (English)......................................... (ii). L.T.I of the Candidate
(Hindi)............................................
(AT THE TIME OF THIRD COUNSELLING/ INTERVIEW ONLY)
(i). Full Signature of the Candidate (English)......................................... (ii). L.T.I of the Candidate
(Hindi)............................................
25.
(FOR OFFICE USE OF THE CONCERNED INSTITUTE ON THE BASIS OF FIRST COUNSELLING)
Admit............................................Category............................................Merit Sl. No. of SQR.................................................of UGMAC-2018 and
AIR........................................of NEET(UG)-2018 in the First Year.......................................Branch/ Course of this Institute as He/ She fulfilled all
the requirements of being admitted.
SIGNATURE OF THE
SEAL OF THE INSTITUTE
DIRECTOR/PRINCIPAL
(FOR OFFICE USE OF THE CONCERNED INSTITUTE ON THE BASIS OF SECOND COUNSELLING)
Admit............................................Category............................................Merit Sl. No. of SQR.................................................of UGMAC-2018 and
AIR........................................of NEET(UG)-2018 in the First Year.......................................Branch/ Course of this Institute as He/ She fulfilled all
the requirements of being admitted.
SIGNATURE OF THE
SEAL OF THE INSTITUTE
DIRECTOR/PRINCIPAL
(FOR OFFICE USE OF THE CONCERNED INSTITUTE ON THE BASIS OF THIRD COUNSELLING)
Admit............................................Category............................................Merit Sl. No. of SQR.................................................of UGMAC-2018 and
AIR........................................of NEET(UG)-2018 in the First Year.......................................Branch/ Course of this Institute as He/ She fulfilled all
the requirements of being admitted.
SIGNATURE OF THE
SEAL OF THE INSTITUTE
DIRECTOR/PRINCIPAL
UGMAC ID :7180005955 Printed On: 25-06-2018 [Link] Page: 3/4
Government of Bihar
Online Application Form for attending Counselling for admission to first Year Degree Course in Bihar State Medical / Dental
/ Ayurvedic / Homoeopathic / Tibbi Colleges for the session 2018 on the basis of NEET(UG)-2018.
UGMAC ID Please don't send this Hard Copy to BCECE Board ALL INDIA NEET RANK
7180005955 48547
UGMAC ID:7180005955 NEET(UG)-2018 Reg. No.:40523863 NEET(UG)-2018 Roll No.:502606839 Category:EBC
26. Your Preference/ Choice .
Sl. No. College
1. PATNA MEDICAL COLLEGE, PATNA
2. NALANDA MEDICAL COLLEGE, PATNA
3. I.G.I.M.S. COLLEGE, PATNA
4. DARBHANGA MEDICAL COLLEGE, LAHERIASARAI
5. ANUGRAH NARAYAN MEDICAL COLLEGE, GAYA
6. JAWAHAR LAL NEHRU MEDICAL COLLEGE, BHAGALPUR
7. [Link] COLLEGE, MUZAFFARPUR
8. GOVERNMENT MEDICAL COLLEGE, BETTIAH
9. VARDHMAN INSTITUTE OF MEDICAL SCIENCE AND RESEARCH, PAWAPURI, NALANDA
10. KATIHAR MEDICAL COLLEGE, KATIHAR
11. MATA GUJARI MEMORIAL MEDICAL COLLEGE, KISHANGANJ
12. NARAYAN MEDICAL COLLEGE & HOSPITAL, SASARAM
13. PATNA DENTAL COLLEGE, PATNA
14. BUDDHA INSTITUTE OF DENTAL SCIENCE AND HOSPITAL, KANKARBAGH, PATNA
15. MITHILA MINORITY DENTAL COLLEGE AND HOSPITAL, DARBHANGA
16. SARJUG DENTAL COLLEGE AND HOSPITAL, LAHERIASARAI, DARBHANGA
17. DR. B.R. AMBEDKAR INSTITUTE OF DENTAL SCIENCE & HOSPITAL, BAILEY ROAD, PATNA
18. RAJKIYA AYURVEDIC COLLEGE, PATNA
19. RAJKIYA HOMOEOPATHIC COLLEGE, MUZAFFARPUR
20. GOVT. TIBBI COLLEGE, PATNA
UGMAC ID :7180005955 Printed On: 25-06-2018 [Link] Page: 4/4
