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Permanent Address

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Registration No.
Father's Name
Gender
Self Mobile
Self E-Mail
Resident No
Office
Mobile
E-Mail
Permanent Address
Town/City
District
State/UT
Country
Pin/Zip
 3010070130 
Bhupinder Singh Chaak
M
9915932732
01832452437
0
9815778159
KOTLI NASIR KHAN
KHAPER KERI
Amritsar
Others
Punjab
India
 143105 
Father's Telephone No:
Program Name
BCA-MCA(Dual Degree) (140 )
Student Details :-
Hostel Detail

26-Feb-1988
Date of Birth
Kulbir Kaur
Mother's Name
Address
Address
Town/City
District
State/UT
Country
Pin/Zip
Correspondence Address (if different from Permanent
KOTLI NASIR KHAN
KHAPER KERI
Others
Amritsar
Punjab
India
 143105 
Resident No
Mother's Telephone No:
Office
Mobile
E-Mail
01832452437
0
Details of hostel facilty of the University availed du
Hostel(on campus/off campus) __________________
Room No  ________________Seater _____________
Sandeep Singh Chaak
Student Name
Batch Year 
 2007
Leet Student
No
Registration No.
 3010070130 
Transportation Detail
Pickup Station
Route Number
Status
Remarks
University/Board
Stream
Exam Name
Qualification Detail
Section.
D37D1
Remarks if Any : 
Availing Laundary Facility
Availing Food Facility
Hostel Name
Room Type
RoomNo
Food remarks if Any : 
Laundary remarks if Any : 
Remarks if Any : 
Aggregate Attendance:

Friday, December 3, 201
0
Printed On
Full Signature of the Student
Date.........................
Place........................

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