Submit Date : 10/11/2024 [Link] Correction Date : --NA-- Print Date : 05/12/2024 [Link] Office Copy
MBM UNIVERSITY, JODHPUR
Examination Form (Main) - Session ( 2024 - 2025 )
REGULAR Student B.E.(CBCS) ENGINEERING Total Fee : 1500
Ist SEM
Subject : Civil Engineering
DEPARTMENT OF CIVIL ENGINEERING (MBM ENGG. COLLEGE)
Form No. : 12216319 Roll No./Reg. No. : M24U715434
Student Name : ARYAN SAMRIA Gender : MALE
Student Name(H) : Date of Birth : 19/04/2006
Father's Name : ASHOK KUMAR SAMRIA Nationality : INDIAN
Father's Name(H) : Caste : Scheduled Caste
Mother's Name : GEETA SAMRIA Other Category
Mother's : Is Orphan : NO
Name(H)
Medium : ENGLISH Minority : NO
Domicile : Rajasthan Mobile No. : 8209328183
Enrollment No. : NO Religion : Hindu
Blood Group : AB+ Is PH/ Blind : NO
E-Mail Id : samriarahul1997@[Link] Address : A-144 SECTOR 8 VIDHYADHAR
NAGAR,Rajasthan,JAIPUR,302039
Aadhar No : 930970229437 ABC No : 843059663422
Candidate's Bank Details
Bank Name A/C Holder Name Account No. IFSC Code Relation With A/C Holder
CENTRAL BANK OF INDIA ARYAN SAMRIA 5667202458 CBIN028333 SELF
5
Details of last Qualifying Examination Passed
Qualification Name of Board/ University Max Marks Obtained Passing Year Percentage
Marks
12th Central Board of Secondary Edu. 2, 500 362 2023 72.40
Community Centre, Shiksha Kendra,
Preet Vihar, Delhi-110 092.
10th Central Board of Secondary Edu. 2, 500 367 2021 73.40
Community Centre, Shiksha Kendra,
Preet Vihar, Delhi-110 092.
Candidate's Identification Details
10th RollNo 10th Marksheet Sr. No. 10th Passing Year
1181516 0075032 2021
Main Papers Main Papers Fee Details
Page 1
S Paper Code Paper Name Degree Year/Sem Head Name Amount
No Exam Fee 1500
.
1 FCC21A (CHY) ENGINEERING CHEMISTRY B.E.(CBCS)
ENGINEERING Ist
SEM
2 FCC21B (CHY) CHEMISTRY LAB B.E.(CBCS)
ENGINEERING Ist
SEM
3 FCC22A (MA) MATHEMATICS - I B.E.(CBCS)
ENGINEERING Ist
SEM
4 FCC31A (CE) CIVIL & ENVIRONMENT ENGINEERING B.E.(CBCS)
ENGINEERING Ist
SEM
5 FCC31B (CE) CIVIL ENGINEERING LAB B.E.(CBCS)
ENGINEERING Ist
SEM
6 FCC32A (SE) ENGINEERING MECHANICS B.E.(CBCS)
ENGINEERING Ist
SEM
7 FCC32B (CE) ENGINEERING GRAPHICS B.E.(CBCS)
ENGINEERING Ist
SEM
8 FCC33A (EE) BASIC ELECTRICAL ENGINNERING B.E.(CBCS)
ENGINEERING Ist
SEM
9 FCC33B (SE) ENGINEERING MECHANICS LAB B.E.(CBCS)
ENGINEERING Ist
SEM
10 FCC34B (EE) BASIC ELECTRICAL LAB B.E.(CBCS)
ENGINEERING Ist
SEM
11 FCC35B (ME) WORKSHOP PRACTICE - I B.E.(CBCS)
ENGINEERING Ist
SEM
Certified that all above entries are correct to the best Certified that all above entries are checked and All entries has been verified and checked through
of my knowledge and belief, I am not appearing in verified by faculty college and student is eligible to record and documents provided by student. Student
any other University examination and there is no UM appear in above mentioned examination. is qualified / not qualified to appear in B.E.(CBCS)
case against me. I have deposited Examination fee. Examination fee has been deposited through Online ENGINEERING Ist [Link] pending ................
Fee once deposited will not be refunded. payment and all marksheets has been attached with
exam form by the student.
Signature of Student Signature and seal of Dean/Head/Principal Full signature of checker in University
Page 2
Signature
Document Enclosed
1. Examination Fees Receipt
2. Last Examination Marksheet(Photocopy with self attest)
3. PH/Blind category certificate(in case of student belongs to PH/Blind category)
Note: Self Attest Photocopy of All The Above Document to be Enclosed.
Before submitting Examination. Please check Eligibility.
Page 3
Submit Date : 10/11/2024 [Link] Correction Date : --NA-- Print Date : 05/12/2024 [Link] Student Copy
MBM UNIVERSITY, JODHPUR
Examination Form (Main) - Session ( 2024 - 2025 )
REGULAR Student B.E.(CBCS) ENGINEERING Total Fee : 1500
Ist SEM
Subject : Civil Engineering
DEPARTMENT OF CIVIL ENGINEERING (MBM ENGG. COLLEGE)
Form No. : 12216319 Roll No./Reg. No. : M24U715434
Student Name : ARYAN SAMRIA Gender : MALE
Student Name(H) : Date of Birth : 19/04/2006
Father's Name : ASHOK KUMAR SAMRIA Nationality : INDIAN
Father's Name(H) : Caste : Scheduled Caste
Mother's Name : GEETA SAMRIA Other Category
Mother's : Is Orphan : NO
Name(H)
Medium : ENGLISH Minority : NO
Domicile : Rajasthan Mobile No. : 8209328183
Enrollment No. : NO Religion : Hindu
Blood Group : AB+ Is PH/ Blind : NO
E-Mail Id : samriarahul1997@[Link] Address : A-144 SECTOR 8 VIDHYADHAR
NAGAR,Rajasthan,JAIPUR,302039
Aadhar No : 930970229437 ABC No : 843059663422
Candidate's Bank Details
Bank Name A/C Holder Name Account No. IFSC Code Relation With A/C Holder
CENTRAL BANK OF INDIA ARYAN SAMRIA 5667202458 CBIN028333 SELF
5
Details of last Qualifying Examination Passed
Qualification Name of Board/ University Max Marks Obtained Passing Year Percentage
Marks
12th Central Board of Secondary Edu. 2, 500 362 2023 72.40
Community Centre, Shiksha Kendra,
Preet Vihar, Delhi-110 092.
10th Central Board of Secondary Edu. 2, 500 367 2021 73.40
Community Centre, Shiksha Kendra,
Preet Vihar, Delhi-110 092.
Candidate's Identification Details
10th RollNo 10th Marksheet Sr. No. 10th Passing Year
1181516 0075032 2021
Main Papers Main Papers Fee Details
Page 4
S Paper Code Paper Name Degree Year/Sem Head Name Amount
No Exam Fee 1500
.
1 FCC21A (CHY) ENGINEERING CHEMISTRY B.E.(CBCS)
ENGINEERING Ist
SEM
2 FCC21B (CHY) CHEMISTRY LAB B.E.(CBCS)
ENGINEERING Ist
SEM
3 FCC22A (MA) MATHEMATICS - I B.E.(CBCS)
ENGINEERING Ist
SEM
4 FCC31A (CE) CIVIL & ENVIRONMENT ENGINEERING B.E.(CBCS)
ENGINEERING Ist
SEM
5 FCC31B (CE) CIVIL ENGINEERING LAB B.E.(CBCS)
ENGINEERING Ist
SEM
6 FCC32A (SE) ENGINEERING MECHANICS B.E.(CBCS)
ENGINEERING Ist
SEM
7 FCC32B (CE) ENGINEERING GRAPHICS B.E.(CBCS)
ENGINEERING Ist
SEM
8 FCC33A (EE) BASIC ELECTRICAL ENGINNERING B.E.(CBCS)
ENGINEERING Ist
SEM
9 FCC33B (SE) ENGINEERING MECHANICS LAB B.E.(CBCS)
ENGINEERING Ist
SEM
10 FCC34B (EE) BASIC ELECTRICAL LAB B.E.(CBCS)
ENGINEERING Ist
SEM
11 FCC35B (ME) WORKSHOP PRACTICE - I B.E.(CBCS)
ENGINEERING Ist
SEM
Certified that all above entries are correct to the best Certified that all above entries are checked and All entries has been verified and checked through
of my knowledge and belief, I am not appearing in verified by faculty college and student is eligible to record and documents provided by student. Student
any other University examination and there is no UM appear in above mentioned examination. is qualified / not qualified to appear in B.E.(CBCS)
case against me. I have deposited Examination fee. Examination fee has been deposited through Online ENGINEERING Ist [Link] pending ................
Fee once deposited will not be refunded. payment and all marksheets has been attached with
exam form by the student.
Signature of Student Signature and seal of Dean/Head/Principal Full signature of checker in University
Page 5
Signature
Document Enclosed
1. Examination Fees Receipt
2. Last Examination Marksheet(Photocopy with self attest)
3. PH/Blind category certificate(in case of student belongs to PH/Blind category)
Note: Self Attest Photocopy of All The Above Document to be Enclosed.
Before submitting Examination. Please check Eligibility.
Page 6
