NAVODAYA VIDYALAYA SAMITI JAWAHAR NAVODAYA VIDYALAYA SELECTION TEST LATERAL ENTRY-CLASS IX APPLICATION FORM REGISTRATION NO.

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1 REGISTRATION NO.: Name of the SOURAV THAKUR Mother's Name SHANKARILATA THAKUR Father's Name SHYAMAL THAKUR Name of the SHANKARILATA THAKUR Relationship with MOTHER INDIAN Date of Birth 27-Nov-2004 Present Postal Address VILL GHOLA, PO GHOLA, PS GANGNAPUR, DIST NADIA : Telephone - Mobile No Gender MALE Category SC Marital Status UNMARRIED Identification Mark A MOLE ON FACE NABATIRTHA CO ED. URBAN RANAGHAT - II RANAGHAT DHANTALA 10-Jan Dec-2017

2 REGISTRATION NO.: Name of the PRATYAY DUTTA Mother's Name MALATI DUTTA Father's Name PRODIP KUMAR DUTTA Name of the - Relationship with - INDIAN Date of Birth 17-Apr-2004 Present Postal Address VILL-JAGADANANDAPUR FULTALA POST-BETHUADAHARI PS-NAKASHIPARA : Telephone - Mobile No Gender MALE Category GENERAL Marital Status UNMARRIED Identification Mark CUT MARK ON FOREHEAD BHAKTIVEDANTA NATIONAL SCHOOL RURAL NABADWIP SRIMAYAPUR 30-Jan Mar-2018

3 REGISTRATION NO.: Name of the TAJMIRA KHATUN Mother's Name MAMTAJ BIBI Father's Name CHHANARUL SARDAR Name of the FARMER Relationship with FARMER INDIAN Date of Birth 01-Feb-2005 Present Postal Address VILL - LALNAGAR, P.O - FAZILNAGAR, DIST - NADIA, PIN : Telephone - Mobile No Gender FEMALE Category GENERAL Marital Status UNMARRIED Identification Mark NO NARAYANPUR HIGH SCHOOL RURAL KARIMPUR II AMIYA NARAYANPUR 14-Jan Dec-2017

4 REGISTRATION NO.: Name of the AHELI MONDAL Mother's Name CHAITALI DAS MONDAL Father's Name AJAY KUMAR MANDAL Name of the AJAY KUMAR MONDAL Relationship with FATHER INDIAN Date of Birth 30-Jan-2004 Present Postal Address 207C,HALISAHAR STATION ROAD,PIN ,DIST-24PGS-NORTH, WEST BENGAL : Telephone - Mobile No Gender FEMALE Category SC Marital Status UNMARRIED Identification Mark MOLE RIGHT SIDE FOREHEAD NARAYANA SCHOOL URBAN KALYANI RATHTALA,KALYANI,NADIA 05-Apr Apr-2018

5 REGISTRATION NO.: Name of the PRITAM SARDAR Mother's Name RATNA SARDAR Father's Name BHISMA DEV SARDAR Name of the BHISMA DEV SARDAR Relationship with FATHER INDIAN Date of Birth 20-Jul-2004 Present Postal Address ANATHESWAR ROAD, SANKAR MISSION PARA, P.O-KRISHNAGAR, DIST-NADIA : Telephone - Mobile No Gender MALE Category ST Marital Status UNMARRIED Identification Mark NA KENDRA VIDYALAYA BSF RURAL KRISHNAGAR I SHIMULTALA, P.O-KRISHNAGAR, DIST-NADIA, PIN Apr Mar-2018

6 REGISTRATION NO.: Name of the PRITAM SARDAR Mother's Name RATNA SARDAR Father's Name BHISHMA DEV SARDAR Name of the BHISHMA DEV SARDAR Relationship with FATHER INDIAN Date of Birth 20-Jul-2004 Present Postal Address ANATHESWAR ROAD, SANKAR MISSION PARA, P.O-KRISHNAGAR, DIST-NADIA : Telephone - Mobile No Gender MALE Category ST Marital Status UNMARRIED Identification Mark NA KENDRIYA VIDYALAYA BSF KRISHNAGAR RURAL KRISHNAGAR I BLOCK SHIMULTALA, P.O-KRISHNAGAR, DIST-NADIA, PIN Apr Mar-2018

7 REGISTRATION NO.: Name of the DEEP BISWAS Mother's Name SABITA BISWAS BARUI Father's Name CHANDAN BISWAS Name of the SBITA BISWAS BARUI Relationship with MOTHER INDIAN Date of Birth 02-Jul-2003 Present Postal Address VILL-RUPASREE PALLY, RANAGHAT, NADIA : Telephone - Mobile No Gender MALE Category SC Marital Status UNMARRIED Identification Mark A CUT MARK ON LEFT KNEE ST STEPHEN SCHOOL URBAN RANAGHAT-II RANAGHAT 28-Apr Mar-2018

8 REGISTRATION NO.: Name of the ARNAB MANDAL Mother's Name LIPU MANDAL Father's Name JAGADISH CHANDRA MANDAL Name of the JAGADISH CHANDRA Relationship with SON MANDAL INDIAN Date of Birth 22-Jul-2003 Present Postal Address DIST NADIA, STATE WEST BENGAL, B-7 175, KALYANI : Telephone - Mobile No Gender MALE Category SC Marital Status UNMARRIED Identification Mark CUT MARK ON LEFT HAND GHOSHPARA SARASWATI TRUST ESTATE VIDYAPITH URBAN GHOSHPARA GHOSHPARA 06-Feb Dec-2017 BENGALI

9 REGISTRATION NO.: Name of the UJJAL SARKAR Mother's Name ROMA SARKAR Father's Name UTTAM SARKAR Name of the UTTAM SARKAR Relationship with SON INDIAN Date of Birth 05-Mar-2004 Present Postal Address STATE-WEST BENGAL, DIST-NADIA, TALTALA,KALYANI : Telephone - Mobile No Gender MALE Category GENERAL Marital Status UNMARRIED Identification Mark CUT MARK ON LEFT HAND GHOSHPARA SARASWATI TRUST ESTATE VIDYAPITH URBAN GHOSHPARA,WARD NO-5,KALYANI VILLAGE 02-Jan Dec-2018 BENGALI

10 REGISTRATION NO.: Name of the JULEKHA KHATUN Mother's Name JAHANNARA BIBI Father's Name SARIYAT SARDAR Name of the - Relationship with - INDIAN Date of Birth 12-Oct-2003 Present Postal Address VILL- LALNAGAR, P.O- FAZILNAGAR, P.S- THANARPARA, DIST- NADIA, STATE- WEST BENGAL : Telephone - Mobile No Gender FEMALE Category GENERAL Marital Status UNMARRIED Identification Mark CUT MARK ON MY LEFT EYE NARAYANPUR HIGH SCHOOL H.S RURAL KARIMPUR II NARAYANPUR 02-Jan Dec-2017 BENGALI