MAHARSHI DAYANAND UNIVERSITY Rohtak -124001, Haryana(INDIA) (A state university established under Haryana Act No. XXV OF 1975) ‘A+ Grade university Accredited by NAAC ‘Application Form- Re-appear/Improvement(uly-2021) Candidate Profile orm Number Borrass70005110%% rented Date: 3/08/2020 Modified Date: licant No h9s7 Student API Ior26053a College Name Eten BASEMESTER emestr/Year f Registration No hstiaTa525 [applicant ull Name raw ate of Birth 5/05/2008 ender FeWaLe ther Name KA CHARAN ° “Mother Name RAMWaAT? —Thans? obile No 95745558 am District Fardabod Contact Details \ddresszH N 97 D BHAGAT SINGH COLONY, SALLABGARH, HARYANA labile No:8595745558 __Emaipoonamkaril01@gmailcom Paper Applied Sujet Siject Nene BamTioe rat INDY CON, ewpear Payment Details ease? S0L7a83700051011 70006 Paa _isaeat :204 AM | solemnly affirm that the above information/entsies made and furnished by me are true and correct Further, | agree to abide by all the rules and regulations of the University, which | have read and understood. In case, any information is found to be false and incorrect, this shall etal automatic ‘eancellation of candidate besides rendering me lable to such action, as the university may deem proper.