INDIAN INSTITUTE OF INFORMATION TECHNOLOGY, BHOPAL

PROVISIONAL REGISTRATION FORM

(Session - Even, 2023 - 2024)

Course To Which Registration Sought : B Tech Registration Date : 13/01/2024

Scholar No : 22U02002
Semester IV
Department Computer Science & Engineering
Course Computer Science & Engineering
Candidate Name ABHISHEK PATEL

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Father/Guardian PURSHOTTAM SINGH

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Name

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Category Other backward Caste

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E-mail abhishekpatel.org@gmail.com Contact No 6306257655

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Residential Status Day Scholar
Present Address 524/A-5 Shiddishwar nagar, ITI Jhansi, Near church jhansi, Jhansi, UTTAR PRADESH, India - 284003

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Payment Details :
Fee Paid Rs. 67500
EG Payment No DUM0874985
Payment Date 08/01/2024
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AL

Signature of Student
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SI

Eligibility Checked for :

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B Tech, Computer Science & Engineering, Computer Science & Engineering IV - Semester
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PR

ASST. REGISTRAR
(Admission)

Enclosures to be enclosed :
1. Fee submission receipt
2. Copy of Mark sheets
 INDIAN INSTITUTE OF INFORMATION TECHNOLOGY, BHOPAL
PROVISIONAL REGISTRATION FORM

(Session - Even, 2023 - 2024)

ONLINE RECEIPT

Online Submission of Registration Form Dated : 13/01/2024

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IO
Student Name ABHISHEK PATEL

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ScholarNo 22U02002

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For Admission in :
Degree B Tech

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EG
Department Computer Science & Engineering
Course Computer Science & Engineering

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Semester IV AL
Fee Amount 67500
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O

Payment No DUM0874985
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Payment Date 08/01/2024

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Date of Submission 13/01/2024

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PR

Signature