MAHARAJA BIR BIKRAM UNIVERSITY Form No.

AGARTALA, TRIPURA. MBBPGFN100476
   

  APPLICATION FORM FOR ADMISSION

      PHOTO
  Acknowledge No.:- 476    Form Submission Date:-   10/09/2020
Academic Year:
DEPARTMENT : ENGLISH
 JUL_DEC_2020
SEMESTER  :  3rd Sem COURSE   : MA
Name of the University: MAHARAJA BIR BIKRAM UNIVERSITY  
Name of the Candidate : Niloy Datta
Father’s Name Sankar Kanti Datta
Mother’s Name : Nandita Baidya Datta
Date of Birth: 01-Jan-1998 Gender : M
Category: General Nationality: INDIAN
Religion : Hinduism
Mobile No. 9862748800
Present Address / Address of the Local Guardian:
Present Address :
Harina Sabroom South Tripura
Pincode : 799145 State : Tripura
Email Id : Niloy.champ371@gmail.com District : South Tripura
Permanent Address
Permanent Address : Harina Sabroom South Tripura

Pincode : 799145 State : Tripura

District : South Tripura
Father’s/ Mother’s
Farmer
Occupation :
Annual Family Income (Rs.): 36000.00
Previous Semester Exam Roll No:
University Registration No. 1902470
19212001
     
Signature of the Candidate

     
    For Office Use Only
Recommendation for admission after verification of the above information:

Signature of the HOD/In-Charge                           Signature of the Registrar

Dept. of English/Public Administration/                           MBB University
Applied Mathematics.