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Medi-Caps University Indore

Form – II
Date:

I Enrol. No.
could not attend my classes due to following cause/s:
Sl. No. Cause From------ To--------

Hence, there is shortage of attendance in the following course/s.


Sl. Course Code Name of the Course Attendance %
No. Theory Practical

Kindly permit me to appear in the End Semester Exam.

Signature of the Student Parent Name:


Mobile No: Mobile No.

Verified by (With Date) Forwarded by (With Date)

Class Co-ordinator HOD/FYI


Note: The cause/s must be verified by the HOD

Permitted/Forwarded by (With Date) Permitted/Not Permitted

Dean
Faculty of Engineering Vice-Chancellor

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