RAMAKRISHNA MISSION SHILPAMANDIRA "842 (A Self-Financed Polytechnic) 208, G. T. Road, Belur Math, Howrah-711 202 Affix latest STUDENT'S BIO-DATA 35mm x 30mm Colour Photo NAME FATHER'S NAME ADDRESS (WITH PIN CODE) CONTACT NO. E-MAIL ID DATE OF BIRTH SEX: M F DDIMM/YYYY QUALIFICATION (A) GENERAL ; Division With Percentage Name of Examination Board of Exam. Year of Passing of Marks (B) DIPLOMA IN ENGG. REG. NO. IN DIPLOMA CLASS ROLL NO. Exam 1st Year 2nd Year 3rd Year Average Semester 1st | 2nd | 3rd | 4th | sth | 6th Year of Passing % of Marks Obtained STATE COUNCIL ROLL No NEAREST RLY. STATION casTe:|GEN| sc | st |oBc| PH WILLING FOR FURTHER STUDIES : [YES] NO. HEIGHT : CM, WEIGHT: KG EYESIGHT: EXPERIENCE / VT (IF ANY) : (SIGNATURE WITH DATE)