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Application No: 1199445

Government of Kerala

OFFICE OF THE COMMISSIONER FOR ENTRANCE EXAMINATIONS

Santhi Nagar, Thiruvananthapuram.

KEAM 2011
Marks submission Data Sheet for Engineering Courses 2011

1.Name 2. Postal Address

VINEETH VISWAN THIRUMANGALATHU KIZHAKKETHIL VEEDU ENATHU P O ENATHU PATHANAMTHITTA

3. Application Number 4. RollNumber 5. Board of Examination 6. Register Number 7. Year of Passing 8. Details of Marks entered : Subject 1 Maths 2 Physics 3 Chemistry

1199445 125816 Kerala Higher Secondary 7037508 2011

Mark Secured 77 116 112

Maximum Mark 100 120 120

Register Number 7037508 7037508 7037508

Year of Passing 2011 2011 2011

DECLARATION (To be filled by the candidate) I, . hereby declare that, all the information furnished above are correct to the best of my knowledge and belief and that, I have fully read the conditions of admission to KEAM - 2011 as contained in the Prospectus. I also declare that, the rules and regulations stipulated in the prospectus will be observed and if selected, I agree to join the course to which selected and the college to which allotted. Should it however be found that, any information furnished is untrue, I realize that I am liable to criminal prosecution and also agree to forego my seat. Place: Date: Signature of the Candidate
Note: This data sheet duly signed by the candidate along with the copies of the mark sheets of the qualifying examination attested by a gazetted officer should be sent to the Office of the Commissioner for Entrance Examinations on or before the last date specified in the notification.

Date: 07-06-2011 05:56:42 pm

IT Services: NIC Kerala

Ip Address: 117.242.17.81