12/23/2017 https://academicscc.vit.ac.in/student/leave_request_status.

asp

Office of the Chief Warden

HOSTEL STUDENT'S LEAVE FORM

Leave Form Sl.No: 17010282

Reg No 13MSE1149

Student Name M GAUTHAM ASOK

Block Mens Hostel A Block

Room No 1141

Leave Type SEMESTER LEAVE

Exit Date 24-DEC-2017

Entry Date 03-JAN-2018

No. of Days 11
permanent Address 26-1357/2B, NEW BALAJI COLONY,
CHITTOOR,
ANDHRA PRADESH - 517001
28-1357/2B, NEW BALAJI COLONY, CHITTOOR, ANDHRA PRADESH -
Place to Leave
517001
Reason SEMESTER HOLIDAYS

Approved By RAJESH M - - SCSE

Student Signature Parent Signature Hostel Authority

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