EXAMINATION FORM FOR EXAMINATION: May-2011

For Regular Semester Only

Institute Branch Roll No / Name Gender / DOB /B.Gp / Batch Father / Mother Name Mobile / Email / Phone Category Postal Address Institute of Enggineering & Technology, Bhaddal , Ropar B.Tech.(Electronic & Communication Engineering) 100420416007/HARWINDER KAUR Female / 24 Aug 1993 / O+ / 2010 Affix photograph to be attested by principal/ Competent Authority

SUKHWINDER SINGH/PARMJIT KAUR 9855563493/harwinder_1993@yahoo.com/ General VILL.SAMIROWAL,P.O.THANA,TEH.ANANDPUR SAHIB. DISTT.ROPAR VILL.SAMIROWAL,P.O.THANA,TEH.ANANDPUR SAHIB. DISTT.ROPAR / Ropar Subjects in which appearing

Permanent Address / Distt

Subject Code / Paper Id Semester2 AM-102 EE-101 / A0117 HU-101 / A0115 PH-101 / A0113 PH-103 HU-103 ME-104 EE-103 GF

Subject Title / Remarks

T/P

Internal

External

Engineering Mathematics-II/Physics Group / Physics Group Basic Electrical & Electronics Engg/Physics Group / Physics Group Communication Skills/Physics Group / Physics Group Engineering Physics/Physics Group / Physics Group Engineering Physics Laboratory/Physics Group / Physics Group Communication Skills Lab/Physics Group / Physics Group Manufacturing Practice/Physics Group / Physics Group Basic Electrical & Electronics Engg Lab/Physics Group / Physics Group General Fitness/Physics Group / Physics Group

Theory Theory Theory Theory Practical Practical Practical Practical Practical

Yes Yes Yes Yes Yes Yes Yes Yes Yes

Yes Yes Yes Yes Yes Yes Yes Yes No

I have understood all the regulations and its amendments in regard to examinations. I found myself Eligible to appear in Examination. In case University declare me ineligible due to any wrong information submitted in examination form by me, I shall be responsible for the consequences at any stage.

Sign of Candidate ________________________

Date___________________

Certified that the Candidate has completed the prescribed course of study and fulfilled all the conditions laid down in the Regulations for the examination and is eligible to appear in the examination as a regular student of Punjab Technical University. The candidate bears a good moral character and particulars filled by him/her are correct.

Signature of the Principal / Competent Authority (With Seal and Date) ________________________

(Signature of HOD)

Receipt of Regular Examination Form and Examination Fee for Examination May-2011 Received Regular Examination Form of Semester2th and Examination Fee of Rs._________________ and late fee (if any) Rs. ___________ from Student Name:HARWINDER KAUR and Student RollNo:100420416007. Signature of Institute Dealing Head with seal