Reg.

No

EWALEME048
UNIVERSITY OF CALICUT
Details of fee remitted
Amount

Chalan No.

Date of remittance

Name of Treasury

140

64261

4-4-2014

friends calicut

Identifying Officer's

................................................................................................................

Name,Designation and Address

................................................................................................................
.........................

Signature of the Candidate.................................................

(To be signed in the Presence of Identifying Officer)

Signature of Identifying Officer with Seal

(To be signed on the Photograph)

B.Tech Supplementary Examination( Semester - 4 ) MAY 2014

APPLICATION FORM
Name of Candidate

AWH ENGINEERING COLLEGE, KUTTIKATUR

SHAMMAS AHAMED.M.

Date of Birth

04.09.1993

Permanent Address
Present Address

ARAFA (H)NAVILAYI (PO) KEEZHARA KANNUR _ 670622

ARAFA (H)NAVILAYI (PO) KEEZHARA KANNUR _ 670622

Phone

9400010557

Centre and Place of Examination

Details of papers for which candidate is applying now

( SUP )

ME09 406

THERMODYNAMICS

I hereby certify that the entries made above are correct to the best of my knowledge

Place :

Date :

Signature of Candidate