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Course Applied for : M.M.S.(with Credits) - Regular - Rev16 - F.Y. M.M.S. Sem I (-) PRN:2015016402446361
Application Date : 25/08/2018
Exam Center Name [Code] : - [-]
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed on Mark CHATURVEDI TANU ANIL REEMA
sheet : [*This name will appear on all University records/documents]
Father's/Husband's Name : ANIL CHATURVEDI Mother's Name : REEMA
Marital Status : UnMarried Mother Tongue :
Place Of Birth : DABRA Gender : Female Date Of Birth (DD/MM/YYYY) : 31/12/1997
Blood Group : Religion : Country of Citizenship :
Height : Not Available Weight : Not Available Hemoglobin : Not Available
Is Student NRI/ Foreign National : No Domicile State:
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Thane Tehsil : Ambarnath City/Town/Village :
Available
Address (House
204,VARDHAMAN EMPIRE,BEHIND T.V TOWER,SHIRGAON Pin Code : 421513
no,street/area/suburb etc.) :
Contact details
Mobile Number 919890872525 Email ID: CHATURVEDIREEMA6@GMAIL.COM
2.Legal Reservation Information
Category Type : Open Category :
Is Specially Abled? No
3.Social Information(Additional Inforamtion)
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25/08/2018
Place : Date :
( Signature of the Candidate )
For College/Institute/Study Center Use Only
Designation Remarks / Particulars / Recommendations Signature and Date
Admission Clerk
Admission
Committee
Accountant/Cashier Cash Received: Rs. Receipt No.: Date:
Registrar/Office
Superintendent
Document printed on Sat Aug 25 2018 14:48:30 GMT+0530 (India Standard Time)
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