INDUSTRY INSTITUTE INTERACTION CELL (IIIC), KITS WARANGAL

STUDENT INSURANCE FORM

S Roll No Name of the Aadhar Name of Date of Nomin Relation

. student card the Birth ee
No Parent Nam
N e
o
Lavudya 79011670482 Lavudya Ravi 7-10-2003 Lavudya Ravi Father
1 B21CS059
Ashwini 6

(Dr. P. Kumaraswamy) (Dr. P.

Asst. Professor & Niranjan)
SPOC, CSED, IIIC, Professor &
KITSW Head.
Dept. of CSE,
KITSW