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Application ID: NRSMC/24/1017
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ENROLLMENT NO: UG101724
FINAL SUBMITTED APPLICATION | Printed on: 09/08/2025 11:40:47 | This is the official submitted version, not a preview

N R S MEDICAL COLLEGE & HOSPITAL

APPLICATION FOR ADMISSION TO ug COURSE

Academic Year 24-25

Basic Information

NEET UG Roll No: 4613040503
All India Rank: 9666
Category Rank: 4365
Registration Year: 24
Category: ug
Candidate Name: Anusmita Ghosh
Date of Birth: 20-08-2004
Gender: Female
Age on 31.12.2025: 20 Years
Physically Challenged: No
Sub Category: UR(General)

Academic Information

Board/Examination: Central Board Of Secondary Education | Year of Passing: 2022
Subject Marks Obtained Total Marks Percentage
10+2 P+C+B 251 300 84%
10+2 English 88 100 88%
NEET-UG 675 - 100%

Contact Information

Email ID: ghoshmukta999@gmail.com
Mobile No: 9062543730
Blood Group: B+
Type: SQ
Hostel Accommodation: Yes
Scholarship: No

Family Information

Father's Name:
Chinmoy Ghosh
Father's Occupation:
Business
Father's Contact:
7076174663
Mother's Name:
Mukta Ghosh
Mother's Occupation:
Homemaker
Mother's Contact:
8240957962
Guardian's Name & Relationship: Chinmoy Ghosh, Father | Occupation: Business | Contact: 7076174663
Annual Family Income: 840000

Address Information

Permanent Address:
4, Vivekananda Road, East Kalianibas
Present Address:
4, Vivekananda Road, East Kalianibas
Block: -
City: Barrackpore
District: 24 Parganas North
State: West Bengal
Pincode: 700122
Aadhar Number: 624620316257

Banking Information

Bank Name: State Bank of India
Account No: 32259593622
IFS Code: SBIN0010091

Documents

Photograph
Photograph
Signature
Signature
Declaration

I hereby certify that the above information given are true and correct as to the best of my knowledge. These particulars cannot be changed till the candidate completes internship. All official communications will be made in these contact details.

Date: 09/08/2025      Place: _________________      Signature: _________________