sever Print Registration Form ‘Veer Bahadur Singh Purvanchal University, Jaunpur ae aera: Rie afea Fakta, orgy ‘Ustteren word af - 2017-2018 B.TECH. 1 SEM. FORM NO, 280670375 COURSE APPLIED FOR MECHANICAL STUDENT TYPE BACK PAPER ENGINEERING STUDENT NAME PRAMOD KUMAR GENDER : VALE FATHER'S / HUSBAND NAME | BHUVAL PATEL MOTHER'S NAME RAJADEAL DEVI NAME OF COLLEGE (001 - VEER BAHADUR SINGH PURVANCHAL UNIVERSITY JAUNPUR DATE OF BIRTH 10/03/1991 CATEGORY : OBC RELIGION : HINDUISM MOBILE NO. 9721770216 ‘SUB CATEGORY NOT APPLICABLE NATIONALITY: INDIAN ENROLLMENT NO,:PU 14/265 ‘AADHAR NO! 357135770208, SUBDECT/PapeR OPTED S.No. UBIECT PAPER PAPER NAME 1 (MECHANICAL ENGINEERING 7 MATHEMATICS T 2 ENGG. PHYSICS I 4 ENGINERING MECHANICS ‘6 COMPUTER CONCEPTS & PROGRAMMING IN 9 PROFESSIONAL COMMUNICATION EXAMINATION NAME |YEAR ROLLNUMBER | COLLEGE/UNIVERSITY OBTAINED MARKS | MAX MARKS INTERMEDIATE 2011 1836574 SVSICSUANGANIJAUNPUR 343 500 [MAME AND COMPLETE MAILING ADDRESS OF CANDIDATE. PRAMOD KUMAR C/O BHUVAL PATEL AFFIX HERE YOUR RECENT PASSPORT SIZE PHOTOGRAPH. ‘ADDRESS: VILL JOGIPUR POST GHURIPUR DISTT JAUNPUR , POST OFFICE : GHURIPUR , DISTRICT/CITY : JAUNPUR STATE : UTTER PRADESH DECLARATION BY THE CANDIDATE (SIGNATURE OF THE CANDIDATE) CERTIFICATE BY THE DEAN /HOD/ PRINCIPAL CeRrieieo THar SiR1/H/SHT PRAMOD KUMAR s 2ONAFIED STUDENT OF THE COLLEGE / UNIVERSITY. ALL THE DOCUMENTS OF QUALIFVING EXAMINATIONS MENTIONED SIGNATURE OF OFFICE ASSISTANT (BEAN /HOD/ PRINCIPAL SIGNATURE WITH SEAL) (0a VeeR BAHADUR SINGH PURVANCHAL UNIVERSITY ip studertrogistration vbspucrams comCampus irmrintRegistralonFormaspx7Skatert ID=Njcw’tzct "