Government of Bihar

Bihar Combined Entrance Competitive Examination Board

Diploma Certificate Entrance Competitive Examination- 2025
Online Application Form for admission in Various Diploma Courses of Govt. / Pvt. Polytechnic Institutions of Bihar and Various
Para Medical Matric (Matric Level) and Para Medical (Intermediate Level) of Different Govt. / Pvt. Recognised Hospitals /
Institutions (as per prospectus) for the Session 2025

Registration No. Please do not send this Confirmation Page to BCECE Board
2511205188695

Personal Details:
Name of Examination : DCECE-2025

Course Group Applied For : PE, PM

Candidate's Name: ISHANT RAJ

Father's Name: INDRAJEET KUMAR

Mother's Name: SUNITA KUMARI

Date Of Birth: 01-01-2006

Gender: Male

Category: Backward Class [BC]

Mobile No.: 950****084

Email Id: the*********************com

Class 10th Roll No. (As printed on Admit Card): 200*119

Note : Please Affix your same photo and put
Permanent resident of Bihar: Yes your full signature in English and Hindi in space
provided above
Residential Eligibility:

Disabled Quota: NO
If you unable to write due to permanent loss of limbs / suffering from Cerebral NA
palsy, then do you claim for providing Scribe:
Is your Family [Father/Mother] annual income is less than 8 Lakhs: YES
Do you Claim for Service Men's Quota [SMQ]: No
Are you Son / Unmarried Daughter of Ex-Servicemen / Retired / Serving NA
Military Personnel :
District Name of the Institution of Passing/Appearing in Qualifying Exam: PATNA

Mark of Identification: A MOLE IN RIGHT HAND LITTLE FINGER

Have you already completed ANM Course:

Educational Details:

Level School/ College Board/ University Passing Passing Marks Total Marks % of marks /
Name Name Status Year Obtained CGPA
Class 10th or Equivalent SCPVAH/S BIHAR SCHOOL Passed 2020 424 500 84.8
(All Subject) JAYANTIGRAM EXAMINATION
GULNI HAIDERPUR, BOARD
NALANDA
Class 12th or Equivalent S.U.COLLEGE, BIHAR SCHOOL Passed 2022 386 500 77.2
(PCMB) HILSA, NALANDA EXAMINATION
BOARD

Payment Details:
Payment Mode Journal No./Transaction No. Deposit Date Amount (in Rs.)

UPI: Bank Account BHD548K0K67JBB 2025/05/06T18:19:00 Rs. Eight Hundred and Fifty Only

Registration No.: 2511205188695 Generated On: 06-05-2025 06:21:21 PM Page No. 1

 Government of Bihar

Bihar Combined Entrance Competitive Examination Board

Diploma Certificate Entrance Competitive Examination- 2025
Online Application Form for admission in Various Diploma Courses of Govt. / Pvt. Polytechnic Institutions of Bihar and Various
Para Medical Matric (Matric Level) and Para Medical (Intermediate Level) of Different Govt. / Pvt. Recognised Hospitals /
Institutions (as per prospectus) for the Session 2025

Address Details:

A. Permanent Address: B. Correspondence Address:

Pendapur Pendapur
Kawa Kawa
District: NALANDA District: NALANDA

State: Bihar State: Bihar

Pin Code: 801302 Pin Code: 801302

Declaration by the Candidate:

I ISHANT RAJ declare that the informations 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)

Registration No.: 2511205188695 Generated On: 06-05-2025 06:21:21 PM Page No. 2

 Government of Bihar

Bihar Combined Entrance Competitive Examination Board

Diploma Certificate Entrance Competitive Examination- 2025
Online Application Form for admission in Various Diploma Courses of Govt. / Pvt. Polytechnic Institutions of Bihar and Various
Para Medical Matric (Matric Level) and Para Medical (Intermediate Level) of Different Govt. / Pvt. Recognised Hospitals /
Institutions (as per prospectus) for the Session 2025

(A) Declaration of Candidate:

.........................................................................................................................................................................................................................................

.........................................................................................................................................................................................................................................

.........................................................................................................................................................................................................................................

.........................................................................................................................................................................................................................................

.........................................................................................................................................................................................................................................

Place : ..............................

Date : .............................. ......................................

(Candidate's Full Signature
(in English))
(Not in Capital letters)

Registration No.: 2511205188695 Generated On: 06-05-2025 06:21:22 PM Page No. 3

 Government of Bihar

Bihar Combined Entrance Competitive Examination Board

Diploma Certificate Entrance Competitive Examination- 2025
Online Application Form for admission in Various Diploma Courses of Govt. / Pvt. Polytechnic Institutions of Bihar and Various
Para Medical Matric (Matric Level) and Para Medical (Intermediate Level) of Different Govt. / Pvt. Recognised Hospitals /
Institutions (as per prospectus) for the Session 2025

(B) Declaration of Father/Mother/Husband/Spouse/Guardian:

ISHANT RAJ

Place : .........................

Date : ......................... ......................................

Full Signature of
Father/Mother/Husband/Spouse/Guardian in
English (Not in Capital letters)

List of Enclosures:

1. ............................................................... 2. ...............................................................

3. ............................................................... 4. ...............................................................

5. ............................................................... 6. ...............................................................

7. ............................................................... 8. ...............................................................

Registration No.: 2511205188695 Generated On: 06-05-2025 06:21:22 PM Page No. 4

 Government of Bihar

Bihar Combined Entrance Competitive Examination Board

Diploma Certificate Entrance Competitive Examination- 2025
Online Application Form for admission in Various Diploma Courses of Govt. / Pvt. Polytechnic Institutions of Bihar and Various
Para Medical Matric (Matric Level) and Para Medical (Intermediate Level) of Different Govt. / Pvt. Recognised Hospitals /
Institutions (as per prospectus) for the Session 2025

(AT THE TIME OF COUNSELLING / INTERVIEW ONLY)

(I.) Full Signature of Candidate (English) ........................

(II.) L.T.I. of the Candidate

(Hindi) ...........................

FOR OFFICE USE OF THE CONCERNED INSTITUTE

Roll No. .............................................. Category .............................................. Merit Serial .............................................. of DCECE-2025 in the First

Year of .............................................. Course of the Institute .............................................. as He/She fulfilled all the requirements of being admitted.

SEAL OF THE INSTITUTE SIGNATURE OF THE DIRECTOR / PRINCIPAL

Registration No.: 2511205188695 Generated On: 06-05-2025 06:21:22 PM Page No. 5