Roll Number: ___________ M.Code.

:____________
______________________________________________________________
Student Personal Information Form
(All information should be written in your own handwriting on white plain A-4 Sheet)

Student Name: __________________________

Father’s Name: __________________________

Mother’s Name: __________________________

Mobile No.: __________________________

Email Id: __________________________

Roll No.: _______________ Current Semester: ____

Course: __________________________

Branch: __________________________

Place of Appearing in examination: Home / relative home / institute / Other Place

Nature of internet Facility with you: Broad Band/ G3/ G4 etc.________________

Device You have Laptop/Desktop/Mobile (Android /IPhone/Other): _____________

Scanning of answer sheet with Mobile/Scanner/Other: ______________________

Correspondence Address: _______________________________________________

_____________________________________________________________________

Permanent Address: ____________________________________________________

_____________________________________________________________________

Present Location: Village/City: __________________________

District: ______________ State: __________________________

Signature: __________________ Page No.: ______

 Roll Number: ___________ M.Code.:____________
______________________________________________________________
Declaration of Student

1. I_________________________S/o ______________________hereby declare that while

attempting my answer sheet will not use any other person(s), incriminating material or involve in
any wrong activity. If such activity reported by evaluator, then my case should be treated as UMC.

2. If I found sharing the question paper(s)/Answer sheet on digital media or with any other
person, any organization/ institution then my case should also be treated under UMC.

3. If any change/ addition /modification have been found in my scanned copy of answer sheet
then my original answer sheet should also be covered under UMC.

Signature

I hereby also declared that above mentioned information is true and correct to the best of my
knowledge.

Signature

Any Difficulty faced downloading of question paper: ___________________________________

_______________________________________________________________________________

Any Difficulty faced Scanning of Answer Sheet: ________________________________________

________________________________________________________________________________

Any Difficulty faced Uploading of Answer Sheet: ________________________________________

________________________________________________________________________________

Any suggestion(s) _________________________________________________________________

________________________________________________________________________________

Signature: __________________ Page No.: ______

 Roll Number: ___________ M.Code.:____________
______________________________________________________________

Explain the following topic in 10 lines in your own handwriting with black
pen

Q1: Write a brief note on Coronavirus (COVID-19). Why Coronavirus is considered as pandemic?
How its spread can be controlled?

Signature: __________________ Page No.: ______

 Roll Number: ___________ M.Code.:____________
______________________________________________________________

Q 2: What do you understand by Open Book Exam?

Signature: __________________ Page No.: ______