GOVERNMENT OF BIHAR

BIHAR COMBINED ENTRANCE COMPETITIVE EXAMINATION BOARD

BIHAR COMBINED ENTRANCE COMPETITIVE EXAMINATION [LATERAL ENTRY] - 2023
Online Application Form for admission to Second Year of Degree Courses in Engineering at Govt./Pvt. (as per
prospectus) Engineering/ Technical Institutions of Bihar, Second Year of Para Medical Degree Courses at Public
Health Institute, Patna & selected Govt. Medical Colleges of Bihar and Second Year of Pharmacy Degree Course at
Different Govt. Pharmacy Institutes of Bihar.

Registration No.
Please do not send this Hard Copy to BCECE Board
6230006460
PART A
137. Name of Examination : BCECE[LE]-2023

2. Course Group Applied For : BCECE[LE]-ENGINEERING

3. Candidate's Name : ABHISHEK RANJAN

4. Father's Name : AMIT KUMAR

5. Mother's Name : ANITA DEVI

6. Date of Birth : 10 / JANUARY / 1998

7. Gender : MALE

8. Category : BC (BACKWARD CLASS)

9. Mobile No : 766****608

10. Email ID : [email protected]

11. Aadhaar No : N/A

12. Are you permanent resident of Note : Please Affix your same photo and put your full signature in
YES English and Hindi in space provided above
Bihar? :

13. Residential Eligibility :

14. Disabled Quota : NO

15. If you unable to write due to permanent loss of limbs / suffering from Cerebral palsy,
N/A
then do you claim for providing Scribe :

16. District Name of the Institution of Passing / Appearing in 3 YEARS DIPLOMA IN

BHOJPUR
ENGINEERING AND TECHNOLOGY :

17. Mark of Identification : A CUT MARK ON FOREHEAD

18. Educational Details :

% of
School/ College Board/ University Passing Passing Marks Total
Level marks /
Name Name Status Year Obtained Marks
CGPA

CENTRAL BOARD
BAL VIDYA
SECONDARY/STANDARD X OF SECONDARY PASSED 2013 N/A N/A 8.8
NIKETAN
EDUCATION

3 YEARS DIPLOMA IN GOVERNMENT

ENGINEERING AND POLYTECHNIC SBTE PATNA APPEARING 2023 N/A N/A N/A
TECHNOLOGY BHOJPUR

Registration No: 6230006460 Page: 1/6

 19. Payment Details :

Payment Mode Journal No./Transaction No. Deposit Date Amount (in Rs.)

Rs.TWO THOUSAND TWO HUNDRED

UPI 1042701684512108436 20/05/2023 07:24 PM
ONLY

20. Address Details

A. Permanent Address: B. Correspondence Address:

VILL-DHARAMPUR VILL-DHARAMPUR
POST-DHARAMPUR POST-DHARAMPUR
PS-KAKO PS-KAKO
District: JEHANABAD District: JEHANABAD
State: BIHAR State: BIHAR
Pin Code: 804408 Pin Code: 804408

21. Declaration by the Candidate :

I ABHISHEK RANJAN declare that the informations furnished above are correct and I shall forfeit my candidature and will be liable for legal action in
case of any of them is proved to be false at any stage inclusive of admission or thereafter.

Date : .......................

Place : ...................... (Signature in English) (Signature in Hindi)

Registration No: 6230006460 Page: 2/6

 GOVERNMENT OF BIHAR
BIHAR COMBINED ENTRANCE COMPETITIVE EXAMINATION BOARD
BIHAR COMBINED ENTRANCE COMPETITIVE EXAMINATION [LATERAL ENTRY] - 2023
Online Application Form for admission to Second Year of Degree Courses in Engineering at Govt./Pvt. (as per
prospectus) Engineering/ Technical Institutions of Bihar, Second Year of Para Medical Degree Courses at Public
Health Institute, Patna & selected Govt. Medical Colleges of Bihar and Second Year of Pharmacy Degree Course at
Different Govt. Pharmacy Institutes of Bihar.

Registration No.
Please do not send this Hard Copy to BCECE Board
6230006460
PART B
(For Office use only)
Selected for admission (1st Counselling) Selected for admission (2nd Counselling) Selected for admission (Mop-Up Counselling)
Against Roll No........................................... Against Roll No........................................... Against Roll No...........................................
Category.......................................................... Category.......................................................... Category..........................................................
Merit Serial....................................................... Merit Serial....................................................... Merit Serial.......................................................
at...................................................(institution) at...................................................(institution) at...................................................(institution)
in...................................................(Course/Branch) in...................................................(Course/Branch) in...................................................(Course/Branch)

...................... ...................... ...................... ...................... ...................... ...................... ...................... ...................... ......................

Signature of Signature of Controller of Signature of Signature of Controller of Signature of Signature of Controller of
the the verifying Examination the the verifying Examination the the verifying Examination
Candidate Officer BCECEB Candidate Officer BCECEB Candidate Officer BCECEB
(At the time of BCECE[LE]- (At the time of BCECE[LE]- (At the time of BCECE[LE]-
Counselling) 2023 Counselling) 2023 Counselling) 2023

Date : ....................................... Date : ....................................... Date : .......................................

1. Name of Examination : BCECE[LE]-2023

2. Course Group Applied For : BCECE[LE]-ENGINEERING

3. Candidate's Name : ABHISHEK RANJAN

4. Father's Name : AMIT KUMAR

5. Mother's Name : ANITA DEVI

6. Date of Birth : 10 / JANUARY / 1998

7. Gender : MALE

8. Category : BC (BACKWARD CLASS)

9. Mobile No : 766****608

10. Email ID : [email protected]

11. Aadhaar No : N/A

12. Are you permanent resident of Note : Please Affix your same photo and put your full signature in
YES English and Hindi in space provided above
Bihar? :

13. Residential Eligibility :

14. Disabled Quota : NO

15. If you unable to write due to permanent loss of limbs / suffering from Cerebral palsy,
N/A
then do you claim for providing Scribe :

16. District Name of the Institution of Passing / Appearing in 3 YEARS DIPLOMA IN

BHOJPUR
ENGINEERING AND TECHNOLOGY:

17. Mark of Identification : A CUT MARK ON FOREHEAD

Registration No: 6230006460 Page: 3/6

 18. Educational Details :

% of
School/ College Board/ University Passing Passing Marks Total
Level marks /
Name Name Status Year Obtained Marks
CGPA

CENTRAL BOARD
BAL VIDYA
SECONDARY/STANDARD X OF SECONDARY PASSED 2013 N/A N/A 8.8
NIKETAN
EDUCATION

3 YEARS DIPLOMA IN GOVERNMENT

ENGINEERING AND POLYTECHNIC SBTE PATNA APPEARING 2023 N/A N/A N/A
TECHNOLOGY BHOJPUR

19. Payment Details :

Payment Mode Journal No./Transaction No. Deposit Date Amount (in Rs.)

Rs.TWO THOUSAND TWO HUNDRED

UPI 1042701684512108436 20/05/2023 07:24 PM
ONLY

20. Address Details

A. Permanent Address: B. Correspondence Address:

VILL-DHARAMPUR VILL-DHARAMPUR
POST-DHARAMPUR POST-DHARAMPUR
PS-KAKO PS-KAKO
District: JEHANABAD District: JEHANABAD
State: BIHAR State: BIHAR
Pin Code: 804408 Pin Code: 804408

Registration No: 6230006460 Page: 4/6

 21. Declaration of Candidate :

I ABHISHEK RANJAN Son/Daughter of AMIT KUMAR declare that: (a) Informations furnished above are correct and in case any of them is proved to
be false or forged at any stage of my admission to and/ or stay in the Institute, I shall be liable (i) to lose my candidature for admission on the basis of
BCECE[LE]-2023, (ii) for expulsion from the institute if admitted and (iii) for appropriate legal action. (b) In the event of my being admitted to any of the
above Institutions, I shall abide by all the rules and regulations of the Institute and the University concerned.

Repeat below in your handwriting not in capital letters the above mentioned Declaration and put your signature in English and Hindi at the
specified spaces:

.........................................................................................................................................................................................................................................

.........................................................................................................................................................................................................................................

.........................................................................................................................................................................................................................................

.........................................................................................................................................................................................................................................

.........................................................................................................................................................................................................................................

Date : .............................. (Signature in English) ......................................................................

Place : .............................. (Signature in Hindi) ..........................................................................

22. Declaration of the Father / Mather / Guardian (to be filled in his/her own handwriting) :

I ................................................................. declare that in the event of ABHISHEK RANJAN being admitted to any Institute, I shall be responsible for
his/her conduct and undertake to pay all his/her Institute, hostel, mess and other dues regularly till the completion of his/her studies. I further certify
that the information furnished by him/her are correct.

Date : ..............................

Place : .............................. Signature of Father / Mother / Guardian in full ...............................................................

23. List of enclosures :

1. .................................................................................... 2. ....................................................................................

3. .................................................................................... 4. ....................................................................................

5. .................................................................................... 6. ....................................................................................

7. .................................................................................... 8. ....................................................................................

Registration No: 6230006460 Page: 5/6

24.
(AT THE TIME OF FIRST COUNSELLING/INTERVIEW ONLY)

(II.) L.T.I. of the Candidate

(English) ........................
(I.) Full Signature of Candidate
(Hindi) ...........................

(AT THE TIME OF SECOND COUNSELLING/INTERVIEW ONLY)

(II.) L.T.I. of the Candidate

(English) ........................
(I.) Full Signature of Candidate
(Hindi) ...........................

(AT THE TIME OF MOP-UP COUNSELLING/INTERVIEW ONLY)

(II.) L.T.I. of the Candidate

(English) ........................
(I.) Full Signature of Candidate
(Hindi) ...........................

25.
FOR OFFICE USE OF THE CONCERNED INSTITUTE ON THE BASIS OF FIRST COUNSELLING

Roll No. .............................................. Category .............................................. Merit Serial .............................................. of BCECE[LE] in the

Second Year of .............................................. Course/Branch of the Institute .............................................. as He/She fulfilled all the requirements of

being admitted..

SEAL OF THE INSTITUTE SIGNATURE OF THE DIRECTOR / PRINCIPAL

FOR OFFICE USE OF THE CONCERNED INSTITUTE ON THE BASIS OF SECOND COUNSELLING

Roll No. .............................................. Category .............................................. Merit Serial .............................................. of BCECE[LE] in the

Second Year of .............................................. Course/Branch of the Institute .............................................. as He/She fulfilled all the requirements of

being admitted..

SEAL OF THE INSTITUTE SIGNATURE OF THE DIRECTOR / PRINCIPAL

FOR OFFICE USE OF THE CONCERNED INSTITUTE ON THE BASIS OF MOP-UP COUNSELLING

Roll No. .............................................. Category .............................................. Merit Serial .............................................. of BCECE[LE] in the

Second Year of .............................................. Course/Branch of the Institute .............................................. as He/She fulfilled all the requirements of

being admitted..

SEAL OF THE INSTITUTE SIGNATURE OF THE DIRECTOR / PRINCIPAL

Registration No: 6230006460 Page: 6/6