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| FORM NO. |
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COURSE APPLIED |
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| STUDENT NAME |
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GENDER :
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STUDENT TYPE :
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| FATHER'S / HUSBAND NAME |
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MOTHER'S NAME |
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| NAME OF COLLEGE |
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| AADHAR |
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CASTE |
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| D.O.B |
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CATEGORY :
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RELIGION |
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| MOBILE NO. |
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SUB CATEGORY |
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| NATIONALITY |
INDIAN |
ENROLLMENT NO. |
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| SUBJECT/PAPER OPTED |
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| DETAILS OF PREVIOUS YEAR EXAMINATION |
| EXAMINATION NAME |
YEAR |
ROLL NUMBER |
COLLEGE/UNIVERSITY |
OBTAINED MARKS |
MAX MARKS |
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| NAME AND COMPLETE MAILING ADDRESS OF CANDIDATE |
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C/O
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| ADDRESS:
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| PIN CODE :
, DISTRICT/CITY :
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| DECLARATION BY THE CANDIDATE |
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(SIGNATURE OF THE CANDIDATE)
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| CERTIFICATE BY THE DEAN /HOD/ PRINCIPAL |
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DATE
SIGNATURE OF OFFICE ASSISTANT
(DEAN /HOD/ PRINCIPAL SIGNATURE WITH SEAL)
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