11/3/2019 NEET - PG 2020

Applicant Details

Personal Details
Application Seq No Candidate's Name

PG107053 GEDAM PRACHI SANJAY

Father's Name Mother's Name

SANJAY GEDAM NALANDA SANJAY GEDAM

Nationality Gender

INDIAN FEMALE

Date of Birth Religion

02/Dec/1991 BUDDHISM

Category Place of Birth

SC WARDHA , MAHARASHTRA

Are you a person with disability ? Are You Willing to Take up Post Graduate Courses in
Armed Forces Medical Services Institutions
NO
NO

Contact Details
Mobile Number Alternate Mobile Number
9890694043 7030550565

Email ID

GEDAMPRACHI2081965@GMAIL.COM

Identification Details
Identification Identification No.

AADHAAR CARD 802590581036

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Marks of Identification

MOLE OVER LEFT SIDE OF NECK

Correspondence Address
Address Line 1

PLOT NO. 78/81 MISAL LAYOUT

Address Line 2

NEAR VAISHALI PRIMARY SCHOOL, JARIPATKA

Country State

INDIA MAHARASHTRA

City/District Pin Code

NAGPUR 440014

Permanent Address
Address Line 1

PLOT NO. 78/81 MISAL LAYOUT

Address Line 2

NEAR VAISHALI PRIMARY SCHOOL, JARIPATKA

Country State

INDIA MAHARASHTRA

City/District Pin Code

NAGPUR 440014

Academic Details
State of Completion of Class 10th

MAHARASHTRA

State of Completion of Class 12th

MAHARASHTRA

MBBS Details
Country of completion of MBBS Qualification

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INDIA

State

MAHARASHTRA

City University of Completion

NAGPUR MAHARASHTRA UNIVERSITY OF HEALTH SCI

ENCES, NASHIK

Name of College Month and Year of Passing

GOVERNMENT MEDICAL COLLEGE, NAGPUR 24/07/2015

Internship Details
Have you completed Internship

YES

Location of Internship

NAGPUR

Institute of Internship Date of start of Internship

GOVERNMENT MEDICAL COLLEGE, NAGPUR 01/08/2015

Date of completion of Internship

08/08/2016

Medical Council Registration Details

MCI/SMC Registration Type

PERMANENT

MCI/SMC Registration Number

2016125080

State of Registration

MAHARASHTRA

Registration Medical Council

MAHARASHTRA MEDICAL COUNCIL

MBBS EXAMINATION MARKS

1st MBBS Examination-Percentage of marks obtained
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62

2nd MBBS Examination-Percentage of marks obtained

56.54

Final MBBS Examination-Percentage of marks

obtained

56.07

Additional Information
Deported/Rusticated during Medical Course Charged of use of unfair means by NBE/Other
examination body
NO
NO

Have you appeared in NEET PG previously Previous Roll No.

YES 1966097224

Year of appearing
01/2019

Test Center Details

State City

MAHARASHTRA NAGPUR

Payment Details
Amount Payment Transaction No

2750 RHMP8165145502

Payment Status

Successful

Candidate Images Upload Details

Photo

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Signature

Left Thumb Impression

Attachments

To view MCI/SMC registration

certificate of MBBS
QualificationClick here.

Declaration

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NEET PG is a proprietary examination and is conducted by National Board of Examinations. The

contents of this exam are confidential, proprietary and are owned by National Board of
Examinations. NBE explicitly prohibits the candidate from publishing, reproducing or transmitting
any or some contents of this exam, in whole or in part, in any form or by any means verbal or
written, electronic or mechanical or for any purpose. No content of this exam must be shared with
friends, acquaintances or third parties including sharing through online means or via social media.
Social media includes but not limited to SMS, Whatsapp, Facebook, Twitter, Hangouts, Blogs etc
using either one’s own account or proxy account(s). By registering for and /or appearing in NEET
PG the candidate explicitly agrees to the above Non Disclosure Agreement and general terms of
use for NEET PG as contained in this information bulletin, and NEET PG website. Violation of any
act or breach of the same shall be liable for penal action and cancellation of the candidature at
the bare threshold.

I certify that I fulfill the eligibility requirements for NEET PG and have furnished complete and
correct information.
I understand that any instances of furnishing incorrect information detected at any stage of the
selection process will automatically disqualify me from the selection process and I will not be
allowed appear for NEET PG in future.
Similarly, if such instances go undetected during the current selection process but, are detected in
subsequent years, such disqualification will take place with retrospective effect.
I also understand that providing incomplete information will automatically disqualify me from the
selection process.
I have read the information bulletin and do hereby undertake that I will not indulge in any unfair
means/practice for NEET PG.
I understand that the decision of NBE shall be final and binding upon me.
Any dispute concerning NEET PG would be subject to Jurisdiction of the Competent Courts
exclusively at Delhi/New Delhi only.
I will comply with the Non Disclosure Agreement as indicated in the information bulletin. I certify
that I have read and gone through the information bulletin for the exam.

Version 13.07.01

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