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EXAMINATION FORM FOR EXAMINATION: May-2011

For Re-appear Semester Only


Institute Lala lajpat Rai Institute of Enggneering & Technology

Branch B.Tech.(Computer Science Engineering)


Affix photograph to
Roll No / Name 7190302428/ASHISH KUMAR be attested by
principal/ Competent
Gender / DOB /B.Gp / Batch Male / 01 Mar 1989 / A+ / 2007 Authority

Father / Mother Name sh.subhash chander/late smt.savita rani

Mobile / Email / Phone 9876328233/ashish_unforgetable@yahoo.com/01887224323

Category General

Postal Address house no-7,block-t,nangal town ship,distt-ropar,punjab

Permanent Address / Distt house no-7,block-t,nangal town ship,distt-ropar,punjab / Ropar

Subjects in which appearing


Subject Code / Paper Id Subject Title / Remarks T/P Internal External
Semester 1
AM-101 / A0111 Engineering Mathematics-I / Chemistry Group Theory No Yes
Semester 7
CS-408 / A0482 Principles of Engineering Economics & Management Techniques / Theory No Yes
Compulsory
Semester 2
AM-102 Engineering Mathematics-II / Physics Group Theory No Yes

I have understood all the regulations and its amendments in regard to examinations. I found myself Eligible to appear in
Examination. In case University declare me ineligible due to any wrong information submitted in examination form by me, I shall
be responsible for the consequences at any stage.

Sign Of Candidate ________________________ Date___________________

Certified that the Candidate has completed the prescribed course of study and fulfilled all the conditions laid down in the
Regulations for the examination and is eligible to appear in the examination as a regular / ex-student of Punjab Technical
University, Jalandhar. The candidate bears a good moral character and particulars filled by him/her are correct.

Signature of the Principal / Competent


Authority (With Seal and Date) ________________________ (Signature of HOD)

Receipt of Re-appear Examination Form and Examination Fee for Examination May-2011

Received Re-appear Examination Form and Examination Fee of Rs._________________ and late fee (if any) Rs. ___________
from Student Name: ASHISH KUMAR and Student RollNo: 7190302428.

Signature of Institute Dealing Head with seal