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JADAVPUR UNIVERSITY

KOLKATA - 700032,INDIA

Website : www.jaduniv.edu.in

Phone : (033) 2457-2286,2540

GENERATED FROM JUMS

APPLICATION FOR ISSUANCE OF PROVISIONAL PASS CERTIFICATE

Particulars of the Applicant:

Name(in CAPITAL LETTERS): RAJARSHI DEBNATH

Course of Study Passed: BACHELOR OF SCIENCE WITH HONOURS IN GEOLOGICAL SCIENCES
Year of Passing: 2022 Exam. Roll No. of Final Sem.: BGEO226047
Class Obtained: First Class Percentage of Marks Obtained: 78.15
Whether already applied or will apply for Review of aforesaid Result(Yes/No): NO
Registration No.(with Session): 151662 of - Class Roll No: 001920401016
E-mail Address: kundupurnima2015@gmail.com Contact No.(Preferebly a Mobile No.): 6297462998
Result data uploaded from JUMS [no need to enclose photocopy of online grade card]

CLEARANCE REPORT:

Sl.
Section/Office/Department/School Report
No.
01 Muster Roll Section(Please report his / her dues)
02 Dean of Students(Please confirm wheather he/ she is a hostel boarder)
Hostel Supdt.(Please confirm wheather his/her dues,if he/she is a hostel
03
boarder)
04 Accounts(Please mention his/her dues including hostel dues)
Librarian (Please report i)his / her dues, if any
05
ii)whether he / she has returned all books)
Result data uploaded from JUMS [no need to enclose photocopy of marksheet]
Date:
______________________

Signature of Candidate
Provisional Pass Certificate may be / can not be issued

______________________

Cash Section

Fees ₹200 to be paid to Jadavpur University cash counter along with this application.
The application form for Provisional Certificate must be signed by candidate.
System generated Provitional Certificate will be available at student portal withing 3 working days of
making
payment at Jadavpur University cash counter.
It remains valid till date of the respective Convocation.

For Use of Cash Section

Received ₹ Two Hundred Only for Provisional Certificate.
Scroll No:
Date: ______________________

Cashier