Applicant Details Hall Ticket

Personal Details
Application Seq No Candidate's Name

55001220 HARI BASKAR SUBBUKRISHNAN

Father's Name Mother's Name

subbukrishnan h girija g

Nationality Gender

Indian Male
Date of Birth

29/Jul/1979

Contact Details
Mobile Number Alternate Mobile Number

8281393955 6238554177

Email ID

drhariba@gmail.com

Identification Details
Identification Identification No.

Aadhar Card 378390126407

Are you a Physically Handicapped Candidate?

No

Correspondence Address
Address Line 1
FLAT NO 1A, CITYSCAPE APARTMENT, PATTERI

Address Line 2
NEAR DESHAPOSHINI PUBLIC LIBRARY, KUTHIRAVATTOM POST

Country State

India KERALA

City Pin Code

Kozhikode 673016

Post Graduate Qualification Details

Type of PG Qualification
MD
 Country of completion of Post Graduate Qualification

India

State
ASSAM

City University of Completion

Cachar OTHERS

University Name Name of College

ASSAM UNIVERSITY OTHERS

Name of Other College Name of Speciality

SILCHAR MEDICAL COLLEGE DNB/MD Radiodiagnosis

Date of joining Date of Qualifying PG Qualification

01/06/2009 31/05/2012

Qualification Details
Super Speciality Program 1
Neurovascular Intervention

MCI/SMC Registration Number Medical Council

55451 Kerala Medical Council

MBBS/Primary Medical Qualification

Name of the course
MBBS

Country of completion of Course

India

State of Completion
TAMIL NADU

City of Completion University of Completion

Chennai DR. MGR EDUCATIONAL AND RESEARCH INSTITUTE (DEEMED
UNIVERSITY), CHENNAI

Name of College Name of Other College

OTHERS STANLEY MEDICAL COLLEGE

Date of joining Date of Completion

01/07/1996 23/02/2002

Additional Information
Deported/Rusticated during Medical Course
No

Charged of use of unfair means by NBE/Other examination body

No
Test Center Details
State City
Tamil Nadu Chennai

Payment Details
Amount Payment Transaction No
3750 QHMP7815149922

Payment Status

Successful

Candidate Images Upload Details

Photo

Signature

Thumb Impression

Declaration

FET 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 FET the candidate explicitly agrees to the
above Non Disclosure Agreement and general terms of use for FET as contained in this Information Bulletin, and FET 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 FET 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 FET 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 provision of 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 FET.
I understand that the decision of NBE shall be final and binding upon me.
Any dispute concerning FET 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