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BIRLA INSTITUTE OF TECHNOLOGY, MESRA, RANCHI

FORMAT FOR STUDENTS' DETAILS


Student ID
Title (Mr. Ms. Mrs.)
First Name
Middle Name
Last Name
Is Duplicate Student (Yes/No)
Year1 (% marks)
Year2 (% marks)
Year3 (% marks)
Year4 (% marks)
Year5 (% marks)
Mother's Name
Father's Name
Res Phone
Mobile No.
Gender
Date of Birth (DD/MM/YYYY)
Student Status
Course
Programme
Level (UG/PG)
Full Time/Part Time
Admission Type
Left the Course
Date of Admission (DD/MM/YYYY)
Academic Year
Left the course Date
Roll Number
Record Created On
Email Address
Alternate e-mail address
Admitted under TFW
Religion
Category as per Caste/Validity Certificate

78/1049
Mr.
KODUKULLA
SHANMUKHA RAGHAVA
AKHIL
No

K VENKATA PADMAVATHI DEVI


K V SANGAMESWARA PRASAD
9493435081
8333942496
MALE
16/01/1997
BACHELOR OF ENGINEERING
EEE
UG

2014-2018
BE/10574/2014
2k7xlcrs@gmail.com
prasad_kodukulla@yahoo.com
HINDU

This is to certify that all above information furnished by me are true to the best of my knowledge and belief

UTE OF TECHNOLOGY, MESRA, RANCHI


MAT FOR STUDENTS' DETAILS
Reserve Category
Is Physically Handicapped / Persons with Disability (PwD)
Econ Backward
Home/Hostel
Institute Fees Paid
Hostel Fees/Month
Is Duplicate
Disclaimer
Exam Type
GATE/GPAT Score
GATE/GPAT Exam Number
GATE/GPAT Score-Year Vallid From
GATE/GPAT Score-Year Vallid To
Category as per GATE/GPAT Score Card
GATE Examination Paper
% Marks Obtanied (GPAT)
Marks Out of 100 (GATE)
Qualifying Marks (GATE)
Do you have an Aadhar Card
Aadhar ID (UID)
NPR Card Number
Claimed Upto Month
Claimed Upto Year
Paid Upto Month
Paid Upto Year
Enrolment ID (EID)
Permanent Address Line 1
Permanent Address Line 2
Permanent Address Line3
Home State of the Student
Home District of the Student
Country
Pincode

NO
NO
NO
HOSTEL-12
RS.1,04,500(as of 4/8/2016)
RS.3000(approx)

598273175669

K.S.R AKHIL S/O Mr. K.V.S PRASAD


TEACHER,SAINIKSCHOOL KORUKONDA
VIZIANAGARAM,ANDHRA PRADESH
ANDHRA PRADESH
VIZIANAGARAM
INDIA
535214

my knowledge and belief


KSR Akhil

4/08/2016
Signature of the student with date

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