Reffered By
Quota
Degree Applied
Course Applied
PERSONAL DETAILS
Name
DOB
Gender
Blood Group
Nationality
Religion
Category
Reservation
Mobile
WhatsApp No
Land Phone No
E Mail ID
Communication Address
Permanent Address
Proposed Residence
Hostel
Bus
Father
Contat No
Father Qualification
Father Occupation
Mother
Contat No
Mother Qualification
Mother Occupation
Annual Income
Local Gaurdian
Contact No
Relationship
Physically Handicapped
Ex-Service man
NSS / NCC
Notes
Image
Signature
EDUCATIONAL DETAILS
SSLC
School/Institution
Board
Reg No
Pass Month / Year
Mark

PLUS TWO
School/Instituion
Board
Reg No
Pass Month / Year
Mark

DETAILS
Subject	Max Marks	Marks Obtained	Grade	Chances
PART I : ENGLISH

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