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Acad07

INDIAN INSTITUTE OF TECHNOLOGY MADRAS

CHENNAI-600 036, INDIA
ACADEMIC SECTION
PROFORMA FOR THE MAKE-UP EXAMINATION FOR MISSED END-SEMESTER
(JULY-NOV 2003)
1. Name

2. Roll No.

3. Batch

4. Branch

5. Semester

6. Room No. & Hostel:

7. Make-up exam required course(s) details:

Sl.No.

Date:

Course No. & Title

Slot

Date of exam

No. of
days
Leave
taken

Name of the teacher in capital

letters and his signature

Signature of the student

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1. A student who misses both quizzes and end-semester examination in the same course is eligible for
make-up only for end-semester examination and zero mark will be awarded for the quizzes.
2. For all subjects of the missed quizzes and End Sem. Exam, one form only to used.
3. Original medical certificate should be enclosed with this form as per instructions given in the reverse
page.
4. For missed Quiz II Examinations, make-up examination form has to reach the Dean, Academic
Courses on or before 5.12.04
5. Forms received after the due date will not be considered under any circumstances.
To
The Dean, Academic Courses

RULES RELATING TO PRODUCTION OF MEDICAL CERTIFICATE ALONG WITH MAKEUP APPLICATION FORM ARE AS FOLLOWS
(effective from July 2003 semester)
1. Students residing in the hostels should produce a Medical Certificate issued by the Chief Medical
Officer of IIT Madras that he was admitted in the Hospital during the period of missed
Quiz/examination
2. Students residing in the Hostels and taking medical consultation with outside Doctors are required to
obtain written permission form the Chief Medical Officer, Institute Hospital, IIT Madras, before they
proceed for consultation, or within three days of the date of joining after illness. Otherwise, the sick
student has to visit one of those hospitals under the Mediclaim Insurance Scheme.
3. Students staying outside the campus permanently or temporarily have to produce medical certificate
for in-patient treatment from the Institute Hospital or from any of the approved hospital under the
Mediclaim Insurance Scheme and the same be duly endorsed by the parent/guardian.

Deputy Registrar (Academic)