Fields marked in * are mandatory PERSONAL INFORMATION FORM

Applicant's Name Pamuru /NagalakshmiI

(Block letters) First Name
Middle Name Last Name
*Present Address(Block Letters) Permanent Address(Block Letters)
Flat no : 501,Maple Homes Flat no : 501,Maple Homes

,Road No :3B,Gopal Nagar,KPHB, ,Road No :3B,Gopal Nagar,KPHB,

Near Gokul PlotsHyderabad : 500085 Near Gokul PlotsHyderabad : 500085

*Tel. *Tel.

Mobile nos. :9010061353 Mobile nos. :9010061353

PHOTOGRAPH
(Please affix your recent passport size
photograph)

Celebrated Birthday:-
e-mail ID :nagalakshmireddy438@gmail.com *Date of Birth 14/08/1992
14/08/1992

*Gender:-Female Male Female *Nationality:-

Indian Blood Group:- A+
*Marital Status Married Single Married Date Of Marriage (If Married) 17 Nov 2016
Family Details
Dependent
Relationship Name Age *Occupation (Pls mention the profession)
(Y / N)
P Srinivasulu Reddy 55 Died N
Father

P Vanaja 45 Tailor Y
Mother

G Vamsi Krishna Reddy 35 Software Engineer(Team Lead) Y

Spouse

Brothers / Sisters

G Charan Tej Reddy 3Yrs Y

Children

*Choose Occupation from - Armed Forces/Business/Self Employed professional/Service-Private sector/Service-Public Sector

Education Details (Start from class 10th & include your professional qualifications) If any computer course please specify it as other qualifications

From To *Degree /
*Reg/Cor *Board/University Name of the Institution *Marks (%) Main Subjects
(mm/yy) (mm/yy) Diploma
2007 2008 10th Reg SCC Sangamithra Vidhyalayam 60%

2008 2010 12th Reg Intermediate Sri chaitanya Junior College 65% MPC

2010 2014 BE Reg JNTU Anatapur DBS Institute of Technology 69.95% ECE

Do you have a valid Passport ? Yes / No. If, Yes please furnish the following details.

Passport Number R0141369 Valid From : 05/23 /2017 Valid Till : 05/22/ 2027
mm dd yyyy mm dd yyyy

Pamuru Nagalakshmi Hyderabad

Name as Given in the Passport Place of Issue
Pan Card Number CBEPP5087M