Application for issue of Provisional Pass Certificate

Name: __________________MUKUL BAJAJ____________________________________

(in Block Letters)

Registration No.: 1 5 1 3 0 1 0 5 2

Address: _______________NEAR OLD POST OFFICE VPO MUKANDPUR DISTT. SBS

NAGAR, PUNJAB___________________________________________________

______________________________________________________PIN 1 4 4 5 0 7

Mob. No. 7 0 7 3 8 2 3 1 7 4

Programme/Specialization B.A.LL.B. (HONS.)

Total Credits earned/CGPA 250/9.67

DETAILS OF FEE PAID

(Amount of Rs._________500______ in favour of “Manipal University Jaipur” payable at Jaipur.)

DD No.___________________________ Date_________________
Name of Bank_______________________________________________________________

Signature of the Student Verified of finance Section Signature of HoD

For Official Use

Total Credits___250__________ CGPA__9.67___________

Provisional Certificate Sr.No____________________________________________

Signature of the Official Dispatched on________________