KALOJI NARAYANA RAO UNIVERSITY OF HEALTH SCIENCES,

WARANGAL, TELANGANA STATE: 506007.

APPLICATION FORM FOR OFFICIAL TRANSCRIPT OF THE EXTRACT OF MEMORANDUM OF

MARKS & THE DETAILS OF EXAMINATIONS

PASSED IN_______________________________________________________________________ COURSE.

(APPLICATION SHOULD BE FILLED IN BLOCK LETTERS ONLY)
Name of the Candidate
01.
(AS PER PROVISIONAL CERTIFICATE )
Date of Admission into
02.
course
03. Name of the Course / Specialty

04. Registration Number

05. Name of the College

06. Date of completion of Internship
07. Month and Year of Passing
Division Awarded in
08.
Provisional Certificate
D.D.No: Date:
09. Details of fee paid
Amount: Bank:

FOR THE USE BY PRO CELL OF ADDRESS FOR COMMUNICATION WITH

KNR UHS, WARANGAL. MAIIL ID AND PH NO,

_________________________________________________________ ________________________________________________________

________________________________________________________ ________________________________________________________

_______________________________________________________ _______________________________________________________

________________________________________________________ ________________________________________________________

_______________________________________________________ _______________________________________________________

Date : ……………………………………………… SIGNATURE OF THE CANDIDATE

Details of Marks Obtained:
Theory / Theory / Theory /
Sl. Year of Course Practical - Practical - Practical - No of
Month & Year
(I/II/III/ Name of the Subjects of Pass of Remarks
No. Final year) Maximum Passing Marks Attempts
Examination
Marks Marks Awarded

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

FOR THE USE OF PRINCIPAL ONLY

Certified that the details furnished above by Mr. / Ms. / Dr. ____________________________________________
__________________________________ are verified and found correct. The Applicant has no dues to this College.
Hence, there is no objection for issue of Official Transcript certificate to him / her.

Place:

Date:

(Signature of the Principal with office seal)

 OFFICIAL TRANSCRIPT : Documents to be enclosed (Xerox Copies):
1. The Demand Draft of Rs.2000/- should be obtained from any Nationalized Bank in
favour of THE REGISTRAR, KNRUHS, WARANGAL and payable at Warangal.
2. A letter from college principal addressing the Controller of Examinations regards (NO
OBJECTION / NO DUE).
3. Application form of Official Transcript of the Extract of Memorandum of Marks
4. Intermediate Certificate.
5. Copy of proceedings issued by KNR UHS in case of change in Name/Surname.
6. All years Marks Memos (Including failed memos, Absent / Not Registered /
Detained Memos)
7. Provisional Certificate.
8. Internship Certificate. (IF APPLICABLE)
9. Permission letter in case of Internship transfer. (IF APPLICABLE)
10. All the documents must be enclosed in the above order only.
Note: All the above certificates should be attested by the concerned College Principal.

*****