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Https Nextbasic - Aiimsexams.ac - in RegistrationSlip Index Id 7Kd98GMGkO+GheQoCGnFEw

The document is a registration form for Lakshit Singh Pawar for the Mock/Practice Test of the National Exit Test (NExT) at the All India Institute of Medical Sciences. It includes personal details such as date of birth, contact information, and identification marks. The candidate has declared the information to be correct and acknowledges the consequences of providing false information.

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8 views1 page

Https Nextbasic - Aiimsexams.ac - in RegistrationSlip Index Id 7Kd98GMGkO+GheQoCGnFEw

The document is a registration form for Lakshit Singh Pawar for the Mock/Practice Test of the National Exit Test (NExT) at the All India Institute of Medical Sciences. It includes personal details such as date of birth, contact information, and identification marks. The candidate has declared the information to be correct and acknowledges the consequences of providing false information.

Uploaded by

vankatraju
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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All India Institute of Medical Sciences

Ansari Nagar, New Delhi - 110608

Registration and Basic Candidate Information Form - Mock/Practice Test of National Exit Test (NExT)

Candidate Profile Registration ID: N1001057878 Registration Date: 08/07/2023

Candidate Name: LAKSHIT SINGH PAWAR

Date of Birth: 12 Feb 2000 Category: General

Gender: Male Marital Status: Unmarried

Father's Name: MANOJ PAWAR Mother's Name: GEETA PAWAR

PWBD Status: No PWBD Category: NA

Nationality: INDIAN

Identification Mark(1): Small Spot above right upper lip Identification Mark(2):
Small spot in front of left ear

Contact Details

Address for Permanent: Correspondence Address:


K-65D KRISHNA NAGAR , HANUMAN CHOWK, Krishna Nagar , RAMA UNIVERSITY, OLD BOYS HOSTEL, Mandhana , Kanpur Nagar, UTTAR
East Delhi, DELHI, India, 110051 PRADESH, India, 209217

Mobile No: 1. 8383825229 , 2. No E-Mail ID: [email protected]

Valid Photo Identity (To be presented in original at the Examination Center along with Admit Card)

ID Proof: Adhar Card ID No: 7955 9098 8895 Place of Issue: India Issue Date: NA Valid Till: NA

UNDERTAKING/DECLARATION: I hereby declare that the information furnished by me in the Registration/Application Form is correct and nothing has been concealed.
In case any information furnished by me is found to be false/incorrect/untrue than i shall be liable to civil/criminal prosecution and my claim to
admission/appointment/registration/ service in the Institute may be cancelled/terminated.

Signature of Candidate
Thumb of Candidate

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