UNIVERSITY OF CALCUTTA

87/1, College Street, Kolkata - 700073, West Bengal, India

Application Form for Under Graduate Examinations

Date - 22/12/2021
Application Id. - 2101141297

Examination - B.Sc. SEMESTER - V (HONOURS) Examination (Under CBCS), 2021

To
The Controller of Examinations
University of Calcutta

Sir / Madam,
I request permission to present myself at the ensuing examination and furnish the required particulars as follows:

Name : RAHUL MUKHERJEE

Father's/ Guardian's Name : TARANI MUKHERJEE

Registration No. : 135-1111-0254-19
Roll No. : 193135-21-0107
Date of Birth : 19/09/2000
Physically Challenged : No
Gender : Male
Mobile : 7479334882
College Code : 135
E-mail : rahulmukherjee8899@gmail.com
College Name : VIDYASAGAR COLLEGE
Communication Address : Vill+P.o-chanduliP.S-KatwaDis-Purba BarddhamanPin no.-713502

Subject(s)/Course(s) to appear & Fees to be deposited:

Srl. No. Subject Course Course Name COMPONENT Total Amount

Code Code
(TH/P/TU) Rs.
1 PHSA CC11 Electromagnetic Theory TH P 0.00
2 PHSA CC12 Statistical Physics TH P 0.00
3 PHSA DSE-A2 LASER AND FIBER OPTICS TH TU 0.00
4 PHSA DSE-B2 NUCLEAR AND PARTICLE PHYSICS TH TU 0.00

Examination & other Fees to be deposited by the candidate to the College 0.00

*TH=Theory,P=Practical,TU=Tutorial Total 0.00

I declare that if any of the statement made in the above is found to be untrue or if it appears that, in the opinion of the University, I
have contravened the provisions of the University Rules and Regulations relating to the examination to which I now seek
admission, my candidature for the examination shall be liable to be cancelled by the University.

Date: Full Signature of the applicant with Date

N.B.
1. Last date of submission of the form to the College by the Candidate - 28/12/2021
2. Candidates are required to submit the form to their College only.
3. For any change or correction, please contact your college.

CHALLAN COPY FOR CANDIDATE

Received an amount of Rs.0.00 from RAHUL MUKHERJEE having Registration No. 135-1111-0254-19 and Roll
No.193135-21-0107 as examination & other relevant fees for B.Sc. SEMESTER - V (HONOURS) Examination (Under CBCS),
2021, after proper verification of all conditions including attendance as prerequisite of the candidate(as per extant regulation) to sit
for the said examination.

Date: (Signature of dealing person with college seal)