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AFTCertificate

This document is an application form for obtaining a transcript certificate from Srimanta Sankaradeva University of Health Sciences. It requires personal information, examination details, fee payment information, and a declaration by the applicant. Instructions emphasize the need for completeness, proper documentation, and submission of self-attested identity proof.

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7 views1 page

AFTCertificate

This document is an application form for obtaining a transcript certificate from Srimanta Sankaradeva University of Health Sciences. It requires personal information, examination details, fee payment information, and a declaration by the applicant. Instructions emphasize the need for completeness, proper documentation, and submission of self-attested identity proof.

Uploaded by

buddygsd25
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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SRIMANTA SANKARADEVA UNIVERSITY OF HEALTH SCIENCES

(A State University of the Govt. of Assam)


Narakasur Hilltop, Bhangagarh, Guwahati-781032, Assam
Phone: 6026177313 (O) E-mail: [email protected] Website: www.ssuhs.in
APPLICATION FORM FOR TRANSCRIPT CERTIFICATE
Note: PLEASE READ INSTRUCTIONS GIVEN BELOW CAREFULLY

1 Name of Candidate :

2 Father’s Name : Paste


Recent
3 Contact Address of the Student : Photograph
of the
Student

4 University Registration No : of
(Enclose Photocopy of Registration Certificate)
5 Name of the Examination/Course:

6 Purpose for which Transcription:


is required

7 Fee details :
(Online Receipt No. & Date of payment)

8 Particulars of Examination Passed. (Please attach Photocopies of all the Marksheets)

Duration of Year of
Examination Annual/Supplementary Roll No.
Course Passing

Telephone (Mobile): Email:

DECLARATION BY THE APPLICANT


I declare that the above entries in the form have been filled up in my own hand-writing and the entries made are
correct as per my documents and to the best of my knowledge and belief. I agree that if any statement made above is proved
to be false, I shall be liable for legal action for submitting false information and statements. I have attached all required
documents (Self Attested) with this application form.

Date : ….............................
Place : …............................. Signature of the applicant in full
Forwarded by:

Principal/ Director/ Head of the Institution


(Signature, Seal (with name) and Date)

INSTRUCTIONS
1 The application must be complete in all respect for processing at the University.
2 Incomplete application form shall not be processed.
3 The form is to be filled in Students own hand writing, in BLOCK LETTERS only.
4 The applicants are to pay the requisite fee through online payment gateway available in SSUHS website (Fee
Collect). A copy of E-Receipt is to be submitted along with the Application Form.
5 The student is required to submit self-attested valid Photo Identity & Address Proof for collecting the Transcript
from the University.

***************

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