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Date: 03-Apr-2015 e-Receipt for State Bank Collect Payment SBCollect Reference Number DU14462721 Category UG Entrance Exam - 2015 Full Name of the Candidate SANTOSH KUMAR PATI Gender Male Date of Birth 16/4/1996 Name of the Father SUDHANSU SEKHAR PATI Name of the Mother KUSUMA PATI Address (Do not use comma) DIST-JAJAPUR PO-755009 Mobile Number (10 digits) 7789952538 e-mail ID [email protected] State of Domicile ODISHA Reserved Seat Category GEN Name of the 10th Board BSE Odisha Total marks in 10th Exam 600 Marks secured in 10th Exam. 514 Exam place preference 1 Cuttack Exam place preference 2 Bhubaneswar Application Fee 1000 Transaction charge 12.36 Total Amount (In Figures) 1,012.36 Total Amount (In Words) Rupees One Thousand Twelve and Paise Thirty Six Only Remarks Notification1 Print a copy of the e-Receipt subsequent to successful payment and bring the same to the Examination Centre. Notification2 Download the Form A-cum-Admit Card from OUAT website http://ouat.ac.in after 10th May 2015. State Bank of India https://www.onlinesbi.com/prelogin/suvidhachallan.htm 1 of 1 03-04-2015 15:47

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Page 1: State Bank of India Pati

Date: 03-Apr-2015

e-Receipt for State Bank Collect Payment

SBCollect Reference Number DU14462721

Category UG Entrance Exam - 2015

Full Name of the Candidate SANTOSH KUMAR PATI

Gender Male

Date of Birth 16/4/1996

Name of the Father SUDHANSU SEKHAR PATI

Name of the Mother KUSUMA PATI

Address (Do not use comma) DIST-JAJAPUR PO-755009

Mobile Number (10 digits) 7789952538

e-mail ID [email protected]

State of Domicile ODISHA

Reserved Seat Category GEN

Name of the 10th Board BSE Odisha

Total marks in 10th Exam 600

Marks secured in 10th Exam. 514

Exam place preference 1 Cuttack

Exam place preference 2 Bhubaneswar

Application Fee 1000

Transaction charge 12.36

Total Amount (In Figures) 1,012.36

Total Amount (In Words)Rupees One Thousand Twelve and Paise ThirtySix Only

Remarks

Notification1Print a copy of the e-Receipt subsequent tosuccessful payment and bring the same to theExamination Centre.

Notification2Download the Form A-cum-Admit Card from OUATwebsite http://ouat.ac.in after 10th May 2015.

State Bank of India https://www.onlinesbi.com/prelogin/suvidhachallan.htm

1 of 1 03-04-2015 15:47