Application No 119237446 Category GENERAL

Name of the Candidate ABHISHEK SINGH

Name of the Guardian RAJKUMAR SINGH
Date of Birth 01/1/1993 Gender Male
Course group 43 Test Center NA
Nationality
Course Name MSc Yoga Therapy India

Address
Babu lal sujiya maholiya khatima

Khatima us nagar

Uttarakhand
City Khatima State Uttarakhand Pincode 262308
Email Id1 abhisheksinghosho@gmail.com Mobile No1 7417736964
Email Id2 abhisheksinghosho@gmail.com Mobile No2 7351570768

Payment Details
Payment Instrument No 119237446-1556173227894
Payment Mode CREDIT CARD Date 25/04/2019 Amount 600

Declaration:

I understand that I can apply only once for each program/ group. In case I apply more than once, only one of my application will be
accepted and the application, entrance test fees remitted will not be refunded.

I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. I have read
and understood all provisions of admissions and agree to abide by them. I also affirm that I fulfil the eligibility requirements for the
course/s applied.

In the event of submission of eligibility document from the unrecognized Board/ University, fraudulent, incorrect or untrue
information or suppression or distortion of any fact, like educational qualification, marks, nationality etc. I understand that my
admission is liable for cancellation.

Signature of the Applicant

NOTE :1. Please keep a copy of the filled in application for future reference (Don’t Send the Copy).
2. Application number must be quoted in all future correspondence.
Manipal Academy of Higher Education (MAHE) | Manipal – 576 104, Karnataka State, INDIA
Tel: +91 92437 77700/11/22/33/44 | email: admissions@manipal.edu | Web: www.manipal.edu