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Admi

tCar
dNo
ADMI
TCARD:
NCCCERTI
FICATE‘
C’EXAM-
20

1. Uni
t : 33(
T)bat
tal
i
on
Phot oof
cadetin
2. (
Att
achex
tensi
onpaper
,ifappl
i
cabl
e):
___
___
___
___
___
___
___
__ unifor
m
without
3. Regi
ment
al(
CBSE)Number: TS20SDA565611 headgear
duly
4. Rank : CPL at t
ested
byOC
5. Namei
nEngl
i
sh(
capi
tal
s) : KALKUDA PRABHAKAR
(
AsperSSCHi
ghSchool
Cer
ti
fi
cat
e)

6. Dat
eofBi
rt
h 01/
01/
2005
(
AsperSSCHi
ghSchool
Cer
ti
fi
cat
e)

7. Fat
her
’s/
Mot
her
’sName: KKI
STAI
AH
(
AsperSSCHi
ghSchool
Cer
ti
fi
cat
e)

8. School
/Col
l
egeandcl
ass sri
sangameshwargovernment
Pol
ytechni
ccol
l
ageranjole
i
nwhi
chst
udy
ing

9. Yearofpassi
ngCer
t‘B’: 2022
(
Att
achphot
ocopy
)

10. Whet
herFr
esh/
Fai
l
ure : FRESH
(
Iff
ail
uredet
ail
sofpr
evi
ous‘
C’ex
am)

11. At
tendancei
npar
ades 3rdyear Total
____
_ __ _
____
12. No/ Nameofcampat
tended(
Att
achphot )Da
ocopy t
e/Mont
h/Year
Locat
ion

1. CATC-|
|
| GDCGAJWEL _
27-
09-
2022t
o04-
10-
2022
2. _
___
___
___
___
___
___ _
___
___
___
___ _
___
___
___
___
___
__
13. Homef ul
laddresswit
hpincodeforpost
aldispatchcert
if
icate:
vil
l
age
kot
hlapurmandalmar pal
l
ydistr
ictvi
kar
abadpi
ncode501202H.NO.1- 125/
1
___
___
__ _
____
______
____
______
____
____
___
____
_ __
______
_______
__
Note:
1.Cadetmustcheckpar t
icular
scaref
ullyandcorrect
ionifany,
bebroughtt
othenoti
ceofOC
i
mmedi atel
y.
2. Thi
scardwil
lbesubmittedalongwithnominalroll
forapproval
ofGpHQaf t
ertheatt
est
ati
onof
phot
obyOCandsi gnatureofall
concerned.
3. Cadetmustbei
npossessi onofthi
scardont hedayofex am.

Si
gnat
ureofcadet Si
gnat
ureofANO Si
gnat
ureofOC

(
_K.PRABHAKAR) (
____
___
___
___
__) (
____
___
___
Name NameandSt
amp Nameandst
amp

Appr
oved/
NotAppr
oved

(
Signat
ureofOI
CExam Cel
l
)

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