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Name of the Student as per 10th Certificate:
Name of the Father:
Name of the Mother:
Gender:
Male
Female
Other
Date of Birth:
Aadhaar Registered Mobile Number:
Alternate Mobile Number:
Email:
Address:
Category:
SC
ST
BC
OC
Name of the Caste:
Religion:
Hindu
Christian
Muslim
Student Aadhaar Card No:
Father Aadhaar Card No:
Mother Aadhaar Card No:
Guardian Aadhaar Card No: (Optional)
Department:
School
Intermediate
Degree
Name of the Previous School/College:
10th Hall Ticket Number:
10th Year of Passing:
Inter Hall Ticket Number:
Inter Year of Passing:
Assisted by: (Optional)
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