* Use only BLOCK LETTERS, Name in | Full i z Branch I fields are mandatory unless otherwise stated. | 1h eutting/overwriting, must be initialised with date, mm INDIAN | | INSTITUTE OF | | TECHNOLOGY Pam ret pear TATE | ardrea wibenfivas) Sie Serving the nation singe 1919, TRAINING AND PLACEMENT CELL. REGISTRATION CARO FOR PLACEMENT For Academic Session | 2023 - | A, PERSONAL DATA Institute Roll No. —— rf ea fSTeTTerE : [ pediieation = 4 ; Tet ome aes 1 a an 2 [11 : uae? hisge. Colour Blindness|v) | Visibility Level (v) = fee [ve [ve [Slo ATE EVE =az | Msi soveet (Tol ols tilsis Te | Va | Passport No PAN No, [Marea | Room SCC OST 1S GiB Wikose | SE "Mobile No.(i) Mobile No.(it) Email ID _49$20¢403 4 | 96SUFD ener PST 7 a ala1[ Father's Name Phone No. with $10. code “Permanent Address: DD 2 - BIndia Mother's Name [Nye \er’s Name Sing | | Mobile No.tou Ls Bhi B, Expreniview Apartmond ) €or 33, few idol Page 1 of 1— Se ] B. ACADEMIC RECORDS coe | ein RL eS eae eee (Poll east OBS (2012 ee Branch Specialization [ Univertysution I ron Bsclitoy) Mate motis | Universi yo Ihe | 2016 | meclttoos) Methemabics, wer, fh pur Del ®| a ReSistsateanitan stir nsteaptgente | a - ——_—___— ' Sea mame | | | 1 L G Experience Details #5 | From To | | | 4 —— T T 1 — : | 3] EEE eer eeeer eer eee [cere eee] eeeeeeeeeeeeet a | 4 | D. CURRENT STATUS OF PhD WORK = Date of Ph.D. Registration | (Expected) Date of Pre- ] (Expected) Date of Thesis | (Expected) Date of Open | Submission Seminar__| Submission Defence DT Fuby QF | EPI | Vere -tt we 207 7) _E. LIST OF PUBLICATIONS | Journals : Page 2 of 1 \c . Workshops! 1 ‘s )_ Present my veeaach wort Se ae hen, 67 nee/STTP attended | BITS = GOA Campus in SJanuany 202.2, =) Aterded. wloceshep at TTT(TS) Dhanbad, "Neen -Lincar thay ad dypamicst deleeitabaieke Sele 32 Merc Seminay qt Miranda Howse, Uni 1 — - : on rp fa yg Scr er te a i = - | | cS = | fo | aot _ a a Se! Ge INTERNSHIPDETANLS 1 HL. Skills, 7 f (i ” » SB ymmng = C+t, MATAR, LATEX sEEEEREECEra sit t \ | r e si — (Grmstivcs Qymavine vomit 268060) MOISS-ee nN BSE Page 3 of 1Ia) Gald Medalist dn fe oe 5) Bowed peu E Cee t Ch. Depaw timo of Sess cf eae i s DECLARATION VERIFICATION TTivvthv cen fv tha Te information provided above s rue and correct and | nave attached Cerilicates as proof forthe entries made neve 2) /nave gone through the Rules & Regulations framed by the Cell avaible at nae placement.itbbu.a¢ in/media/uploacs/placement policy af] 20d | Undertake to abide by the same (Fulbsfgnature of the Student with Date) (Signature and Seal of the Supervisor with The data and information provided by my | this research scholar is correct and the same has been verified by me before forwarding to the TPC. Wares Date) reer /Supervisor onfereties Fre Fear Depanento Vacveatl Simca areca senting Page 4 of 1 ingenhatuacl een Grams as esa) ‘STRTeTeH /“Varanasi-22 1006