UNIVERSITY OF CALCUTTA

87/1, College Street, Kolkata - 700073, West Bengal, India

Application Form for Under Graduate Examinations

Date - 29/01/2019
Application Id. - 15033445
Examination - B.Sc. PART-II(Supplementary) Examination - 2018
(Under 1+1+1 2009 Regulations)

To
The Controller of Examinations
University of Calcutta
Sir,
I request permission to persent myself at the ensuing examination for which I deposit fees and furnish the required
particulars as follows:

Name - SUBHANJAN ADHIKARY

Father's/ Guardian's Name - SUBHASH CHANDRA ADHIKARY

Regsitration Number - 211-1122-0990-14 Roll No- 3211-46-3038

DOB - 06-09-1997
Gender - MALE

College - Code - Name - (211) MAHARAJA MANINDRA CHANDRA COLLEGE

Mobile No. - 8334837875 E-mail - subhanjanadhikary5@gmail.com

Communication Address - 374 Rabindra Sarani, Dum DUm Cantonment, Kolkata-700065

Paper/Subject(s) to appear & Fees to be deposited:

Srl. No. Paper/Subject Code Paper/Subject Name Appear Type Lab Fees (Rs.)
1 MTMG MATHEMATICS (GENERAL)
2 PHSG PHYSICS (GENERAL) Theoretical

Examination & other Fees 355.00

Total Fees to be deposited by the candidate to the College 355.00

I declare that if any of the statement made in the above be found to be not true or if it appears that, in the opinion of the University, I have
contravened the provisions of the University Rules and Regulations relating to the examination to which I now seek admission, my
candidature for the examination shall be liable to be cancelled by the University.

Date: Full Signature of the applicant with Date

N.B.
1. Last date of submission of form to the College by the Student - 31/01/2019
2. Students are required to submit the form along with fees to their College only.

CHALLAN COPY FOR STUDENT

(211) MAHARAJA MANINDRA CHANDRA COLLEGE
Received an amount of Rs.355.00 from SUBHANJAN ADHIKARY having Registration No. 211-1122-0990-14 and Roll No.3211-46-3038
as examination & other fees for B.Sc. PART-II(Supplementary) - Examination 2018
Date (Signature of dealing person with college seal)