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To
The Chief Executive Officer
Bio-chemic Education Grant Commission Govt. of India.
Bakshi Lane ,Bowbazar,P.O-Krishnagar,Dist-Nadia,W.B Pin-741101
PHOTO
ATTACH
3.Present Address:...........................................................................................
............................................................................................
M/F/O
...............................................................................................
4.Permanent Address:.......................................................................................
..................................................................................................
..................................................................................................
5.Date of birth:...................................................................................................
6.Qualification:.................................................................................................
Exam Pass Year Board/Council/University
Full Marks
Percentage
Or Grade
12. Attach Xerox copy of all documents and Original Residential Certificate.
13.Email ID and Mob No.
I do hereby declare that the above particular are true and correct to the best of my knowledge and belief.
Date:
Place: