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