Indian institute of Technology Delhi FORM NO. IRD/REC-12
Tel 9r-9-26091799, 25507834 Fax 11 25054715
mall arrdgam td asin Web hits
ERENT
1. Name in full (in block letters) __BAPAN AD AIC
2. Address in block ttes) |!
()'ForCommumeation” — VA-32, Areavels teste) TOT 4
Reths, Nour Kho, New dela ~ Neer
(i) Prosent A-32 Arcovals Hostel TIT AOtn Heue kis
New Pees = Ute
(i) Permanent Vite Ashanda, Po. Sehibhursut. f.s- Udayrara
a. rah, 5 40g
(iv) Ema: bapan. adakists@ grit L(y) Phonenobite: (2) VF\G634 78>
3. Particulars of age and birth je aeration o equvatert Corto)
(i) Date of Birth (OD-MM-YYY) 20/02) 199 -— (iy Age:
(ii) Place of Birth Havre (i) Nat
4. Other Particulars (Please Tick)
Gender: % Male OO Femate Marital Status: (% single 1] Marriea
& Father's Name aba Kuman Adak Mother's Namo_Z[aithoda _A-Ook
hfe
‘Spouse Name
6. Category(Please Tice: Osc Ost Cloac Oexsmen OPH General
(Please alta photocopy ofthe elvan cericate)
7. Particulars of Qualification and Experience:
(Pease fel fee to atach separalo sheet in cae of raufcent space. Orginal Cerifialeestmeias in cupport
‘walifcaten 8 experence weld be rogue to be shown athe tae of asou’s neg sauces)
() Quant (in reverse chronological ord
Esestonalechnesli | Nan Saect | Grades! | Sofware | —Yeurar oho UaReTaYT
Prestena Exam Division | “cbtaned | passing Boor
Pursung Passed
eee) ed 4342 | aiss| PET Gol
EOE) Re BE |
ea |
2a ea con perro) 64 | 489% | Anjo [Goo Cele fags)
1 padhoaagl (eee Pirhuttincag
| fesaeig-| | ‘Serempace |
a. Hs Gothen) | Setvmee | 86-39% | 2008 Achande Jeter
| dee erie