GOVERNMENT OF GUJARAT Submit Date : 09/11/2024

Application No:
Umbrella Scheme for Education of ST Students Post-Matric 242500000000125347
Scholarship
Renewal Application

Previous Application No: 232400000001347944

Previous Paid Scholarship:

Student Basic Details

Name of Student : ANGARI VIMALABEN FATABHAI

Name of Student (As per Aadhar) : ANGARI VIMALABEN FATABHAI
Mother's Name : MUGLIBEN
Date of Birth : 31/03/1997 Gender : Female
Category : ST(7ȵkɅl‡ISKWĤiS  Religion :Hindu
Caste : Dungri Garasia Ȯk5F^ŽF^hdj]h 

Aadhaar Status Verified: Yes(07/11/2024 15:01:59)

Ration Card No. : 302006004650942 Ration Card Member No. : 102006004650942006

Name As Per Ration Card: (Angari Vimalaben Fatabhai / ӔFh^Žia\`hZpWYSh[h:
EKYC Status As Per Ration Card: Yes EKYC Date: 07-10-2024
Aadhar Number Matched With Ration Card: Yes
Consent Status: I hereby give my consent to use my personal data available with food and civil supply department. I hereby give my consent to
government of Gujarat for fetching my identity for the purpose of post matric scholarship.

Annual Income of Parents/Guardian/Husband (Rs): 38000 Habitation Type: Rural

Mobile Number : 7043240445 E-mail Address : [email protected]
Aadhar No : 44xxxxxx1163 Parent/Guardian occupation: Labour(\ȩl^Ž
Is Orphan: NO Day Scholar / Hosteller : Day Scholar
Marital Status : Unmarried Hostel Type:

Current Address: Permanant Address:

State Gujarat State Gujarat

District Banaskantha District Banaskantha

Taluka Danta Taluka Danta

Village Jharivav Village Jharivav

PinCode 385110 PinCode 385110

Address:AT - JHARIVAV Address:AT - JHARIVAV

Student Bank Account Detail/Aadhar Bank Detail

I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 44xxxxxx1163 Bank name : -
NPCI Date : 11/18/2024 12:00:00 AM NPCI Status : Accept
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 35xxxxxx8964 IFSC Code : SBIN0001697
Student Name(As per Bank Name): vimalaben fatabhai angari

Name of Bank : STATE BANK OF INDIA

Branch Name & Address : AMBAJI

I hereby accept that
1.Details provided by me are correct to best of my knowledge
2.Shall not make any claims if amount is transferred to a wrong account due to incorrect details provided by me

Page 1 of 3 242500000000125347 Print Date :18/11/2024

 3.Shall refund the amount transferred to someone else¶s account due to incorrect details provided by me
4.I will refund the excess amount credited to my account, if any.

Student Academic Details

Present Course/Class/Trade Type: Para medical

Present Course/Class/Trade Name : Post Basic B.Sc(Nursing) Post Basic Bachelor Of Science in Nursing

Present Course/Class/Trade Year : 2ND YEAR(3rd Semester/4th Semester)

Studying in : Gujarat Enrollment No: 2023095900021135

Present Institute District : Mahesana Present Institute : NOOTAN COLLEGE OF NURSING VISNAGAR

Admission Type : Regular Paid Seat (Self Finance) Present Branch Course : -

Present Class Start Date : 01-Sep-2024 Present Course Completion Date : 31-Aug-2025

Fees Amount
Admission Fees (Rs) 0
Tution Fees (Rs) 93000
Misc.Fee(NonRefundable Fees) 0
Exam Fees(Rs) 2000

Total (Rs) 95000

Previous stream :Post Basic B.Sc(Nursing) Post Basic Bachelor Of Previous Class/Course : 1ST YEAR(1st Semester/2nd Semester)
Science in Nursing
Previous Passing Year : 2024 Previous (%) : 67.00

Educational Break : No No. Of. Year in Break :

Are You Employed in any Organization/Establishment with leave without pay? : Not Applicable

Previous Education Detail

Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH SSC A544812 2013 70.66

11th Std/12 Std 12TH HSC G867768 2015 53.06

Para medical Post Basic B.Sc(Nursing) Post Basic Bachelor Of FIRST YEAR PBSC100 2024 67
Science in Nursing 4
Para medical GNM (Genral Nursing & Midwifery) GNM NURSING 2282 2018 64.5

Disablity Detail
Is Disability : No Type of Disability : -

Percentage of disability : - Required Guide/Coaching Guide: No

Guide Name: -
Guide Address: -

List of documents which you have attached :

1 Caste Certificate From the Competent Authorities

2 First Page Of Bank PassBook/Cancelled Cheque

3 Fee Receipt of Current Course Year

4 Self Attested Certificate of Previous academic marksheet

5 Income Certificate From the Concerned Authorised Authority/Persons

6 Std:12 Marksheet(If Any)

7 Identity Card (College/School)

Page 2 of 3 242500000000125347 Print Date :18/11/2024

 I have read all above terms and conditions and understand them fully, I hereby declared that here I am submitting only one
application for scholarship and I haven¶t received any other scholarship/stipend or fellowship in this current session under any other
central/state government scheme. I further state that all information furnished by me is correct to my knowledge in case of any the
false information or suppression of necessary data proved in my application is liable to get cancelled at any stage of the scholarship
process and the entire amount of scholarship will be refunded by me or recovered from me. Government decision shall be final and
binding on me.

Date : 18/11/2024

Verify Mobile Number : Yes 18/11/2024

Place : Signature of the applicant

It is certified that the information filled in the above mentioned fields by the students are correct to the best of my knowledge and
all the Documents has been checked.

It is also certified that in case the applicant leaves institution or otherwise discontinues the studies or detained or accepts any other
regular scholarships/stipend/ fellowship the fact will be immediately reported to the said authority

Certified that the student is eligible for scholarship amount subject to Central/State government rules and the student is
recommended for sanction of scholarship.

This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2024
-2025. If student will irregular, than we will immediately reported to the said authority.

The actual School/College/University year began on __________________ and will be ended on _____________________

Signature Of Head Of The School/College/Institute/University With Official Seal

Place :

*Note : Stamp Signature will not be accepted

Date :

Page 3 of 3 242500000000125347 Print Date :18/11/2024