ANDHRA PRADESH STATE ROAD TRANSPORT CORPORATION

Submitted Time: 12-Jun-2023 09:07

23061211497768

1.Student Details
1.1 Reg Id: 23061211497768

1.2 Student Name: D V S NARAYANA

1.3 Father/Mother's Name: D ABADHAM

1.4 Date Of Birth 05-Aug-2006

1.5 Gender/Age : Male / 16

Venkatarajupuram, Deverapalli, visakhapatnam, Andhrapradesh -531030, VENKATARAJU PURAM(V),

1.6 Address: DEVARAPALLE(M),
VISAKHAPATNAM

1.7 Mobile No. 6302145696

2.Education Particulars 3.Pass/Route Particulars

2.1 Institution Name: GOVT POLYTECNIC VISAKHAPATNAM 3.1 Type Of Pass: Student-General/City

NH-5@@Kancharapalem@@Visakhapatnam 3.2 Bus Pass Name: SGBT QTLY

2.2 Institution Address: VISAKHAPATNAM(U)
VISAKHAPATNAM
3.3 From Place: ---
2.3 Course Name: 3rd year-Dip (Eee)
3.4 To Place: ---
2.4 SSC Details: 2139123346/2021/APSSC/Regular
3.5 Via Place: ---

4.Enclosures
4.1 Enclosures : Bonafied Certificate,SSC Memo

I here by declare that the particulars given above are true and found correct. I will abide by
the rules & regulations of APSRTC governing issue of Bus Passes.

Signature of the candidate

BONAFIDE CERTIFICATE
I here by certify that Sri/kum/Smt D V S NARAYANA is bonafide student of GOVT
POLYTECNIC VISAKHAPATNAM (Name of the Institution) studying 3rd year-Dip (Eee) (Name of the
course) With Admission No 21014-EE-020 & Roll No __________ His /Her Date of Birth is 05-Aug-2006
(DD/MM/YYYY) as per office records and the course will be completed by _______________
(dd/mm/yyyy).Educational Institute Recognition Code No ________________ (As per the D.E.O. records).
Course Code No _____________ for the Academic year 2023-2024.

Date :
PRINCIPAL
Place :

For Office Use Only

Reg Id / M.R.No./ Ack.Receipt No.: 23061211497768 / Receipt Date.: 12-Jun-2023

Center Name : SIMHACHALAM Due Date

Bus Pass Type Student-General/City Manual MR No.

Student Name D V S NARAYANA Pass Amount: ₹ 885 /-

Admission No. 21014-EE-020 ID Charges: ₹ 50 /-

Route Code --- ----- --- Total Amount: ₹ 935 /-

Pass Issued by Route Kms: 0 Km(s)