Annexure ‘B’

Charotar University of Science and Technology (CHARUSAT)

Student Counselling System
Student’s Personal Data Sheet

Primary Details (To be filled by students)

1 Student’s Full Name PATEL DUSHYANTKUMAR MUKESHBHAI
2 Date of Birth 14/08/1995
3 Identity Number 14EE069
4 Current Semester 5TH
5 Email dmpatel1415@gmail.com
6 Phone Number (Personal) 9687846284
Phone Number (Parents/
7 8140307356
Guardians)

RAJKAMAL BUNGLOW, NEAR MOHINI CORNER, OPP.

8 Present Residential Address
ANANDITA FLAT, BAKROL-V V ROAD, V V NAGAR-388120

Name of the local guardian

PATEL JAYRAMBHAI
9 Address and
AS ABOVE
Mobile Number

Permanent Residential AT- VAJAPUR, POST:- NAVASANGHPUR, TAL.:- VIJAPUR, DIST.:-

10
Address MAHESANA, PINCODE:- 382870

11 First Language GUJARATI

Medium of Instruction up to
12 GUJARATI
12th Std.
13 Hobbies and Interests
1 CHESS 5
Indoor Games/ Sports 2 TABLE TENNIS 6
a)
Please Specify: 3 7
4 8
1 CRICKET 5
Outdoor Games/ Sports 2 VOLLYBALL 6
b)
Please Specify: 3 KABBADI 7
4 8
Dance √ Elocution
Music √ Quiz √
Dramatics Debate
Mime √ Drawing √
Other Activities/ Events Stage Décor Rangoli
c)
Please Tick: Anchoring/ Event
Painting
Management
Film Making/ Photography √ Poster Making √
NCC Social Activity/ NSS
 Annexure ‘B’

Any Other Areas of Special

d)
Interest: ----------

Awards/ Achievement, If
14 WINNER AT DISTRICT LEVEL KABBADI
any:
1 Job Placement √
Career Choice/ Goal 2 Entrepreneurial Venture
15 (To be evaluated after 3 Competitive Examination √
completion of 2nd year) 4 Further Studies in India
5 Further Studies abroad
Academic Details (To be Filled in by Students)
Semester Wise CGPA
Semester 1 Semester 2 Semester 3 Semester 4 Semester 5 Semester 6 Semester 7 Semester 8
7.48 7.77 8.32 8.40
Semester Wise Backlog (If any)
Semester 1 Semester 2 Semester 3 Semester 4 Semester 5 Semester 6 Semester 7 Semester 8

Subject(s) with Repetitive Backlogs, if any Number of Repetitions