I THANIKACHALAM PAVITHRA S/D/o THANIKACHALAM resident of 507, KUMARAN STREET ,

LAKSHMIPURAM, KANGEYANALLORE , VELLORE - 632006, TAMILNADU hereby solemnly affirm and

declare that:-

1. I am an Indian national by birth.

2. I have completed 19 years 0 months age in the year of admission in MBBS.
3. I have done my 10th class from AUXILIUM GIRLS HIGHER SECONDARY SCHOOL, VELLORE -
632006, TAMILNADU in the year 2013- 2014 and as per my 10th class records, my date of
birth is 02/01/1999
4. I have studied 11th class with the subjects of TAMIL, ENGLISH, MATHS, PHYSICS,
CHEMISTRY, BIOLOGY in AUXILIUM GIRLS HIGHER SECONDARY SCHOOL, VELLORE-632006,
TAMILNADU in the year 2014-2015 and declared “PASS”.
5. I have studied my 12th class with the subjects of TAMIL , ENGLISH, MATHS, PHYSICS,
CHEMISTRY, BIOLOGY from TRINITY MATRICULATION HIGHER SECONDARY SCHOOL,
VELLORE -632006, TAMILNADU in the year 2016-2017 .
6. I have been granted 12th class passing certificate by the STATE BOARD OF HIGHER
SECONDARY SCHOOL EXAMINATION, TAMILNADU.
7. I had joined in MBBS/equivalent medical course at UNIVERSITY OF NORTHERN PHILIPPINES,
TAMAG, VIGAN CITY, PHILIPPINES in the academic year of 2018
8. I started my Medicine course at UV GULLAS COLLEGE OF MEDICINE, BANILAD, MANDAUE
CITY, CEBU, PHILIPPINES in the academic year of 2019
9. I re enrolled Neurology and Therapeutics after my 3rd year in the academic year of 2022 to
2023
10. I still pursuing my Medicine course at UV GULLAS COLLEGE OF MEDICINE, BANILAD,
MANDAUE CITY, CEBU, PHILIPPINES

DEPONENT SIGNATURE

VERIFICATION :

I THANIKACHALAM PAVITHRA do hereby solemnly affirm and declare that the above Statement
given is true and correct to the best of my knowledge and belief and that nothing has been
concealed there from.

DEPONENT SIGNATURE