Moraj Design and Decorator (DnD) Building, Near Oil Depot, Mihan Fly Over,

Wardha Road, Khapri, Nagpur-441108, Maharashtra, India

Website: www.nlunagpur.ac.in
STUDENT INFORMATION FORM
(Please fill in Capital Letters)

NAME:
________________TANISHQUA_____THOOL_____________________________________
____

FATHER’S_____________ABHAY______THOOL__________________________________
________
NAME

MOTHER’S____________MAMTA______THOOL_________________________________
_________
NAME

COURSE_________________________BALLB(HONS.)_____________________________
___________

DATE OF BIRTH ______29TH MAY 2000__________________ BLOOD

GROUP______A+ve_____________

GENDER _____FEMALE____________
CASTE/CATEGORY______SC_______________________

PERSONAL E-
MAIL:______tanishquathool@gmail.com__________________________________________
_______

PARENTS E-
MAIL:_______thoolmamta26@gmail.com__________________________________________

DESIRED UNIV. E-MAIL (Opt1):_____________________________________________

DESIRED UNIV. E-MAIL (Opt2):_____________________________________________

PERSONAL CONTACT NO.:____8459370366________________________

EMERGENCY CONTACT NO.:_____9423681712_____________________

PERMANENT ADDRESS:

HOUSE NO.________FL. NO. T-1, ANNAPURNA APT-1,

_________________________________________________________

STREET/AREA_______MANISH
NAGAR_______________________________________________________
TOWN/VILLAGE__________NAGPUR___________________________________________
_______

POST OFFICE __AIRPORT SONEGAON___________________ PIN

CODE_________440005_______________________

DISTRICT _____NAGPUR___________________ STATE

_______MAHARASHTRA____________________________

**For Office use only**

UID:____UG-18 108_____________________
Course_____BALLB(HONS.)_______________________

Confidential *For internal use only