Patliputra University, Patna
Type of Exam :
College Name with Code
Course Name
Year / Semester
Subjects
Registration Number
Roll Number
Candidate's Name
Father's / Mother's Name
Category
Sub-Category
Religion
Nationality/Domicile
Date of Birth / Gender
Telephone
Email
Present Address
Permanent Address
Subjects / Papers Details
Subject Papers
Declaration by the Candidate
I, ............................................. on ................... solemnly declare that all the information provided in the form no. ......................... is true to the best of
my knowledge and belief. If any information herewith is found to be untrue / false / incorrect, my candidature / admission / examination is liable to
be cancelled and no claim of its fee refund would be raised by me. If in future, any of this information is found untrue / false / incorrect, the University
may cancel my degree.
अभ्यर्थी का नाम (हिंदी में) (Signature of the Candidate)