Last updated date : 30/12/2022 01:55 PM Date : 11-Apr-2023

Seafarer Profile

Personal Details
Surname / Last Name : PULIKKOTTIL

Given Name : VINESH VARGHESE

INDoS No. : 21EM1284 Discipline : Engineering

Gender : MALE

Date of Birth : 15/10/1996

Place of Birth : DELHI Birth State : Delhi

Birth Country : India Nationality : Indian

Address Details
Present Address Permanent Address
B/202, GEETHANJALI APARTMENT,
Address :
YASHODHAN NAGAR
Address :

: :

: :

City : THANE City : YASHODHAN NAGAR,

Pin : 400606 Pin : 400606

State : Maharashtra State : Maharashtra

Country : INDIA Country :

Telephone No. : 7718954333 Telephone No. : 8355816694

Mobile No. : 8355816694

Email Id : vineshvarghese96@gmail.com

Physical Details

Height (in Cms) : 173 Hair Color : BLACK

Eye Color : BLACK Complexion : WHEATISH

Identification Mark : mole on left hand

Report generated on : 11/04/2023 9.44 PM Page 1 of 10

 Education Details
1 . Education Level : 10TH (Matriculation/SSC)

Main Subjects : ENGLISH,HINDI,MATHEMATICS,SCIENCE&TECHNOLOGY,SOCIAL SCIENCES

Certificate No. : 068577 Year of Passing : 2013
PCM Mark(%) : English Mark(%) :
Result(%)/Grade : 76.36
Name of University : STATE BOARD OF MAHARASHTRA
Name of Institution : ST. JOHN THE BAPTIST HIGH SCHOOL
Institute Address : St John the Baptist High School, Near Talao Pali, Charai, Thane West, Thane, Maharashtra 400601.

3 . Education Level : 10+2 (HSC/Intermediate/equivalent)

Main Subjects : ENGLISH,HINDI,PCM,ECONOMICS,ENVIRONMENT EDUCATION

Certificate No. : 309595 Year of Passing : 2015
PCM Mark(%) : 48 English Mark(%) : 64
Result(%)/Grade : 58.15
Name of University : STATE BOARD OF MAHARASHTRA
Name of Institution : VANI VIDYALAYA
Institute Address : Pandit Jawaharlal Nehru Road,Near Mulund Vidya Mandir, Mulund West, Mumbai - 400080

2 . Education Level : Diploma

Main Subjects : FLUID MECHANICS,THERMODYNAMICS,POWER,AUTOMOBILE

Certificate No. : 17024576 Year of Passing : 2017
PCM Mark(%) : English Mark(%) :
Result(%)/Grade : 70
Name of University : STATE BOARD OF MAHARASHTRA
Name of Institution : FR. AGNEL POLYTECHNIC
Institute Address : Father Agnel Technical Education Complex, near Noor Masjid, Juhu Nagar, Sector 9A, Vashi, Navi
Mumba

4 . Education Level : Graduate (Bachelors Degree)

Main Subjects : FLUID MECHANICS,THERMODYNAMICS,POWER,AUTOMOBILE

Certificate No. : 1761635 Year of Passing : 2020
PCM Mark(%) : English Mark(%) :
Result(%)/Grade : 6.47
Name of University : UNIVERSITY OF MUMBAI
Name of Institution : ST. JOHN COLLEGE OF ENGINEERING AND MANAGEMENT
Institute Address : Village Vevoor, Manor Road, Palghar (East), Palghar District - 401404

Total no of record in Education Details : 4

Pre Sea Training Detail

Report generated on : 11/04/2023 9.44 PM Page 2 of 10

 Pre Sea Training Detail

Training Institute : International Maritime Institute (Greater Noida)

Training Institute (other) :
Course Name : Graduate Marine Engineering
Attended From (Date) : 07/06/2021 Attended To (Date) : 06/06/2022
Certificate No. : 10100431022100112 Result : PASS
Pre Sea Tar Book No. :

Modular Course Details

1 . Course Name : Basic Safety Training

Course Name : Basic Safety Training

Training Institute : International Maritime Institute (Greater Noida)
STCW Code :
Attended From : 28/02/2022 Attended To : 10/03/2022
Certificate No. : 10100461012200512
Date of Issue : 21/03/2022 Valid Upto :

2 . Course Name : Security Trng. for Seafarer with Designated Security Duties

Course Name : Security Trng. for Seafarer with Designated Security Duties
Training Institute : International Maritime Institute (Greater Noida)
STCW Code :
Attended From : 11/03/2022 Attended To : 12/03/2022
Certificate No. : 10100466212200512
Date of Issue : 18/03/2022 Valid Upto :

3 . Course Name : Basic Training for Oil and Chemical Tanker Cargo Operations

Course Name : Basic Training for Oil and Chemical Tanker Cargo Operations
Training Institute : BP Marine Academy (Navi Mumbai)
STCW Code :
Attended From : 13/06/2022 Attended To : 18/06/2022
Certificate No. : 2010015111220829
Date of Issue : 18/06/2022 Valid Upto :

Report generated on : 11/04/2023 9.44 PM Page 3 of 10

 Modular Course Details
4 . Course Name : Basic Training for Liquified Gas Tanker Cargo Operations

Course Name : Basic Training for Liquified Gas Tanker Cargo Operations
Training Institute : BP Marine Academy (Navi Mumbai)
STCW Code :
Attended From : 20/06/2022 Attended To : 24/06/2022
Certificate No. : 20100151212202511
Date of Issue : 24/06/2022 Valid Upto :

Total no of record in Modular Course 4

Certificate of Endorsement
1 . Endorsement : DC ENDORSEMENT ENGINEERING

Endorsement Type : DC ENDORSEMENT ENGINEERING

Level : Support Certificate No. : COPDGSOAC2274833
Issued At : Navi Mumbai
Date of Issue : 22/06/2022 Valid Upto (Date) : 22/06/2027
Remarks :

2 . Endorsement : DC ENDORSEMENT ENGINEERING

Endorsement Type : DC ENDORSEMENT ENGINEERING

Level : Support Certificate No. : COPDGSGAS2275529
Issued At : Navi Mumbai
Date of Issue : 04/07/2022 Valid Upto (Date) : 04/07/2027
Remarks :

Total no of record in Certificate of Endorsement : 2

Authorised Documents
1 . Document Type : Passport

Document Type : Passport

Document Number : Z6146948 Issued Date : 05/10/2020
Valid Upto : 04/10/2030 Issued At : Mumbai

2 . Document Type : INDoS

Document Type : INDoS

Document Number : 21EM1284 Issued Date : 09/06/2021
Valid Upto : Issued At :

Report generated on : 11/04/2023 9.44 PM Page 4 of 10

 Authorised Documents
3 . Document Type : CDC

Document Type : CDC

Document Number : MUM 463187 Issued Date : 02/05/2022
Valid Upto : 01/05/2032 Issued At : MUMBAI

4 . Document Type : Seaman Identification Document

Document Type : Seaman Identification Document

Document Number : M32426584 Issued Date : 27/06/2022
Valid Upto : 26/06/2032 Issued At : Mumbai

Total no of record in Authorised Documents : 4

DECLARATION TO BE MADE BY CANDIDATE :

I hereby declare that the particulars entered in the form are correct and true to the best of my knowledge and belief and that the
papers enumerated in this form are true and genuine documents given and signed by the person whose names appears on them. I
further declare that Seagoing service information entered is a true and correct account of my sea-going service without exception and
I make this declaration conscientiously believing the same to be true. The documents in original will be presented to the examiner at
the time of taking oral examination or at an earlier time when asked by the department.

Signature of the candidate

Date :

This is an electronically generated document hence it does not require any signature of DGS Officials.

Report generated on : 11/04/2023 9.44 PM Page 5 of 10

 Personal Details
Surname / Last Name :

Given Name :

INDoS No. : Discipline :

Gender :

Date of Birth :

Place of Birth : Birth State :

Birth Country : Nationality :

Address Details
Present Address Permanent Address
Address : Address :

: :

: :

City : City :

Pin : Pin :

State : State :

Country : Country :

Telephone No. : Telephone No. :

Mobile No. :

Email Id :

Physical Details

Height (in Cms) : 173 Hair Color : BLACK

Eye Color : BLACK Complexion : WHEATISH

Identification Mark : mole on left hand

Report generated on : 11/04/2023 9.44 PM Page 6 of 10

 Education Details
1 . Education Level : 10TH (Matriculation/SSC)

Main Subjects : ENGLISH,HINDI,MATHEMATICS,SCIENCE&TECHNOLOGY,SOCIAL SCIENCES

Certificate No. : 068577 Year of Passing : 2013
PCM Mark(%) : English Mark(%) :
Result(%)/Grade : 76.36
Name of University : STATE BOARD OF MAHARASHTRA
Name of Institution : ST. JOHN THE BAPTIST HIGH SCHOOL
Institute Address : St John the Baptist High School, Near Talao Pali, Charai, Thane West, Thane, Maharashtra 400601.

3 . Education Level : 10+2 (HSC/Intermediate/equivalent)

Main Subjects : ENGLISH,HINDI,PCM,ECONOMICS,ENVIRONMENT EDUCATION

Certificate No. : 309595 Year of Passing : 2015
PCM Mark(%) : 48 English Mark(%) : 64
Result(%)/Grade : 58.15
Name of University : STATE BOARD OF MAHARASHTRA
Name of Institution : VANI VIDYALAYA
Institute Address : Pandit Jawaharlal Nehru Road,Near Mulund Vidya Mandir, Mulund West, Mumbai - 400080

2 . Education Level : Diploma

Main Subjects : FLUID MECHANICS,THERMODYNAMICS,POWER,AUTOMOBILE

Certificate No. : 17024576 Year of Passing : 2017
PCM Mark(%) : English Mark(%) :
Result(%)/Grade : 70
Name of University : STATE BOARD OF MAHARASHTRA
Name of Institution : FR. AGNEL POLYTECHNIC
Institute Address : Father Agnel Technical Education Complex, near Noor Masjid, Juhu Nagar, Sector 9A, Vashi, Navi
Mumba

4 . Education Level : Graduate (Bachelors Degree)

Main Subjects : FLUID MECHANICS,THERMODYNAMICS,POWER,AUTOMOBILE

Certificate No. : 1761635 Year of Passing : 2020
PCM Mark(%) : English Mark(%) :
Result(%)/Grade : 6.47
Name of University : UNIVERSITY OF MUMBAI
Name of Institution : ST. JOHN COLLEGE OF ENGINEERING AND MANAGEMENT
Institute Address : Village Vevoor, Manor Road, Palghar (East), Palghar District - 401404

Total no of record in Education Details : 4

Pre Sea Training Detail

Report generated on : 11/04/2023 9.44 PM Page 7 of 10

 Pre Sea Training Detail

Training Institute : International Maritime Institute (Greater Noida)

Training Institute (other) :
Course Name : Graduate Marine Engineering
Attended From (Date) : 07/06/2021 Attended To (Date) : 06/06/2022
Certificate No. : 10100431022100112 Result : PASS
Pre Sea Tar Book No. :

Modular Course Details

1 . Course Name : Basic Safety Training

Course Name : Basic Safety Training

Training Institute : International Maritime Institute (Greater Noida)
STCW Code :
Attended From : 28/02/2022 Attended To : 10/03/2022
Certificate No. : 10100461012200512
Date of Issue : 21/03/2022 Valid Upto :

2 . Course Name : Security Trng. for Seafarer with Designated Security Duties

Course Name : Security Trng. for Seafarer with Designated Security Duties
Training Institute : International Maritime Institute (Greater Noida)
STCW Code :
Attended From : 11/03/2022 Attended To : 12/03/2022
Certificate No. : 10100466212200512
Date of Issue : 18/03/2022 Valid Upto :

3 . Course Name : Basic Training for Oil and Chemical Tanker Cargo Operations

Course Name : Basic Training for Oil and Chemical Tanker Cargo Operations
Training Institute : BP Marine Academy (Navi Mumbai)
STCW Code :
Attended From : 13/06/2022 Attended To : 18/06/2022
Certificate No. : 2010015111220829
Date of Issue : 18/06/2022 Valid Upto :

Report generated on : 11/04/2023 9.44 PM Page 8 of 10

 Modular Course Details
4 . Course Name : Basic Training for Liquified Gas Tanker Cargo Operations

Course Name : Basic Training for Liquified Gas Tanker Cargo Operations
Training Institute : BP Marine Academy (Navi Mumbai)
STCW Code :
Attended From : 20/06/2022 Attended To : 24/06/2022
Certificate No. : 20100151212202511
Date of Issue : 24/06/2022 Valid Upto :

Total no of record in Modular Course 4

Certificate of Endorsement
1 . Endorsement : DC ENDORSEMENT ENGINEERING

Endorsement Type : DC ENDORSEMENT ENGINEERING

Level : Support Certificate No. : COPDGSOAC2274833
Issued At : Navi Mumbai
Date of Issue : 22/06/2022 Valid Upto (Date) : 22/06/2027
Remarks :

2 . Endorsement : DC ENDORSEMENT ENGINEERING

Endorsement Type : DC ENDORSEMENT ENGINEERING

Level : Support Certificate No. : COPDGSGAS2275529
Issued At : Navi Mumbai
Date of Issue : 04/07/2022 Valid Upto (Date) : 04/07/2027
Remarks :

Total no of record in Certificate of Endorsement : 2

Authorised Documents
1 . Document Type : Passport

Document Type : Passport

Document Number : Z6146948 Issued Date : 05/10/2020
Valid Upto : 04/10/2030 Issued At : Mumbai

2 . Document Type : INDoS

Document Type : INDoS

Document Number : 21EM1284 Issued Date : 09/06/2021
Valid Upto : Issued At :

Report generated on : 11/04/2023 9.44 PM Page 9 of 10

 Authorised Documents
3 . Document Type : CDC

Document Type : CDC

Document Number : MUM 463187 Issued Date : 02/05/2022
Valid Upto : 01/05/2032 Issued At : MUMBAI

4 . Document Type : Seaman Identification Document

Document Type : Seaman Identification Document

Document Number : M32426584 Issued Date : 27/06/2022
Valid Upto : 26/06/2032 Issued At : Mumbai

Total no of record in Authorised Documents : 4

DECLARATION TO BE MADE BY CANDIDATE :

I hereby declare that the particulars entered in the form are correct and true to the best of my knowledge and belief and that the
papers enumerated in this form are true and genuine documents given and signed by the person whose names appears on them. I
further declare that Seagoing service information entered is a true and correct account of my sea-going service without exception and
I make this declaration conscientiously believing the same to be true. The documents in original will be presented to the examiner at
the time of taking oral examination or at an earlier time when asked by the department.

Signature of the candidate

Date :

This is an electronically generated document hence it does not require any signature of DGS Officials.

Report generated on : 11/04/2023 9.44 PM Page 10 of 10