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INSTITUTE FOR PLASMA RESEARCH
Bhat, Near Indira Bridge, Gandhinagar 382428

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Application for Technical Training Program 2011

Application no. : 600772

Applied for : Both (IPR and ITER-India)

Center Screening Test : Ahmedabad

Affix Your
Discipline : Mechanical
Passport Size
DD Number : 193235
Photo Here
DD-Bank MICR Code : 199193235

DD - Dated : 26/4/2011

Date of Birth : 7/9/1988

Name : patel himanshu bhai

Father/Guardian Name : vayal bhai l patel

Qualifying Degree : BTECH and the year of passsing is 2011

University : Sardar Vallabhbhai National Institute of Technology, Surat , Gujarat

IF OTHER :

Institution/college : sardar vallabhbhai national institute of technology,surat

Final Marks Available : No

Final % of Marks :

Marks(2Sem/1Yr) : 59.99 60.03

12th std. : 60.00 % and passed in the year 2006

10th std. : 74.71 % and passed in the year 2004

Contact Address : c-304,shankheshwar complex, , althan main road , opp. sriram marble,

: surat, Gujarat, 395017

Contact Phones : -, 9427652226

Contact Email-Ids : hpsvnit07@gmail.com, him7777777@gmail.com

I hereby certify that I am an Indian Citizen. The fore-going information is correct to the best of my knowledge and belief. I have not suppressed any material fact or
factual information in the above statement. In case I have given wrong information or suppressed any material fact or factual information, then my services are liable to
be terminated without giving any notice or reason thereof. I am not aware of any circumstances which might impair my fitness for employment under Government.

Place:____________
Signature : ____________
Date : ____________

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