Total Pages: 4 For Office Use only
RX-1
Examination RollNo..........no**********
ALIGARH MUSLIM UNIVERSITY, ALIGARH
Course of Study..******************************************************************************************
Branch/Main Subject/Specialization (if any)*********************************
Year/ParuSemester/Term/Prof..
* ---
******************* CSSIO. **********
PASTE
RX
donot staple)
For Graduation-Subsidiary (1) *m*********** ***** recent
(If applicable) PHOTOGRAPH
Comp.() **** . (.-
dd aeod
***
by the Certufying
Authe rity
Regular Ex-Student
Cash Receipt No. Dated Rs. Enrolment No. Faculty No.
1. Name (in block letters) Mr./ Ms.
As per HSSSC or cquivalent examination)
Date of Binth in Christian Era (In figures)..****************************************************************************************
(In words).. *************************************************************************************
3 Sex **********************************************************************************************************
4. Fathers Name
5. Mother's Name
6. Religion (In case of Muslims, state *********************************************************************************************************
Sunni or Shia)Caste for Non-Muslims Keiigion Sunmo >hia) ( C S T / BC)
7. Permanent Address (in full)
*********************************************************************************************************|
8. Was the candidate ever debamed, disqualified, Examination..
************************************* * *****************************************
detained, suspended, nusticated ?If so. give details Roll No.. .... Period....
(attach photocopies of the Office orders) Punishment awarded.****************************************************************
9. Is the candidate appearing in Improvement
Examination (Yes / No) **********************************************************************************************************
10. 1s the candidate appearing or has appeared at:
any other examination of this University or any
other examining body this year ? If so. give Examining Body...
************************************************************************
details.
11. Details of Examination at which the candidate Regular / Ex-Student..
***********************************************************
last appeared as Regular/Ex-Student but failed Exam. Roll No... ****************....KCSu..... *****************
12. Details of Last Examination Passed:
Name of the Yearof Roll No. Name of University/Board Result
%of Subjects Offered
Examination Passing Marks
Candidate is required to enclose self attested photocopy of marksheet
NOTE: 1 This Examination Formis applicable for Regular Ex-Student, des iring to appear in the examination of the
courses. mentione.n of Reulr EStudents. whichever s applicable as per Ordinances (Academic).
se see th
3. Pleaseseethe back page ofthe Hal-Ticketfor details of Examination Fee payable
21
13. Specily the Papers and their Codes (including PracticalsSeminar/Viva-V oce, etc.). in which the candidate intends to appear in
theExamination.
CODE SO,| TITLEOF PAPERS
************************************************ **************************************************** ********* ********* **********************************
** *** **
*********** ******* ******** ********* ********************************
*** **** ***
** ****** *** ********* * *****
*aa a** *an na******* ********
**
******
***************** ***************** **** ******
*
* * * * * * *** ************* ****************** *** **************************** ****** ********* *****"***************** ************************************ *************** ********* ********
** *** *** *** *** *** ****** *** f ********* *** ********* *** ****** ********* ************ *** ****** ****** *** * ***** ***** * * *** *** *** *** *** *** *** *** ****** *** *** ********* *** *** *** ****** ******** ****** **
* * * * * * *** ****** ****** *** * * * * - * * * * * - * * - *** * - * * * * * - * * * * - * ****-****-* ***--*.-* * **-*****-** **-** ***--* *** *******************************-*****-**-*****-**-**
* * * -** *** ***-** *** *--*** * * - * * * *** *-* *** *-- * - - * - - * * - - * * * **----**- --* -**--***--** *** - * * - - - - - *** ***-** *** --******--** -** ****** *** *** **- *** **- *******-*-***--**--**---*****--***---** -**
****************** **************** * ** ****** **-**** -*****-************************** * ****
* * * *********************| ******** **************************************** **************************************************** ************ ***************************************
* ****** ********* *************************************************************************** *** ********************* ******** ********* ********* *******************************************
* * * * * * * * * * * * * * ****** ** * * * * * * * ****** *** *** *** *** ************ ****** ****** ************ *** ****** ****-* *** *** *** *** *** * * *** *** *** *** *** *** *** *** ********* *** *** ****** ********* *** *****
Backlog Papers (if any
** * * * * *** * * * * * * * * * ****** ** ************ *************** *******nns**************** * * * * * * * * * * * * *** * * * * * * * * * * * * * * * * * * * * * *** *** * * * a * * ****** *** *** *** *** ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
* * ****** *** ****** ****** ** ******** *****************"*********************** *******"************* ********* *** ****** ********* ************** *************************************** ***
* *********** ********** ******************************************************** ****************** *********************** ****************
******************
NOTE: Candidates w ith Madarsa background studying n MA. (Arab ik/lslamic Studies [Link].) Should also clear English Paper of
SSSC evel for award of Degree.
DECLARA TION
Thercby solemnly affirm that I have filled this Examination Fom myselt. It it s discovered at any stage that I have made a false or incorrect
statement or concealed the facts or fraudulent meas have been used by me for appcaring at the examination. I shall be liable to discipl1nary action
and my examination result may be cancelled. I further aftirm that I have not taken Migration Certificate from this University/submitted the
Migation Certificate.
Ishall abide by all the rules and regulations of the University as amended and cnforced from time to time.
**
Hall..**************************************************| **********************
(Signature of the candidate in full)
Address for Dated: .
Hostel. *** ****************** ce
**********************************************
Room ***********************************
eters)
(in Block Letters)
**************************************************************
Left(Male) Pin:
Righ(Female)
Thumb Contact h * **********'********
pessiOin
FOROFFICE USE ONLY
Certificate to besigncd by the
Dean Principal'Coordinator/Direxterconcernsd:This
certity that the student
is to
Certiflcate to besigned by the Provont
Ths is o certify that
(a) is a regularex-student of the course of study as detailed in
this Examination Form.
(a) the candidate Iwas a regular mNmber of this Hall dunng the cTent s¢Ssion dunng the
session... nd hus her Hall dues arc clear as on date. (b) fulfils the conditions as laid down in the Ondinances
(Academic)VRegulatsons relating to the course.
(c) has chosen the Title of papers and their Codes correctly.
SIgnatule (witn * ) .
(d) has subnitted the ornginal marksheet in this office (in case
TOvOst)
ot appearng tor Improvement)
Dated
Signature (with Seal)..
Datcd:. Dean Principal'C-coordinatorDirector
For Ofice Use on
This Page not to be filled in
students of Flo Engg. &
by [Link]./M. Tech.| 13 Examination Roll No..
0......**************** ****
Technoogy
ALIGARH MUSLIM UNIVERSITY, ALIGARH
Regular/Ex | PASTE
(de not staple)
recent
PHOToGRAPH
HALL TICKET ulyattested
Mention the Cole &Title of Papers Practicals Seminar. ete. carefully.
Note:
No Corections / overwnling shallbe accepted unless ventied by the University authority.
y the ertily ing
Course of Study..*************************************************************************************************************************************************************************
Subject/Specialization (if any).
Branch/Main ***************
Year/Partsemester/Term/Prof... **************************************************************************
Regular Ex-Student
Name of the Candidate..
*******************************************************************************************.
.Hal.... . . .
(in Block Letters)
Faculty No.*****************************************************************************
... Enrolment No. *****************************************************************
Papers and their Codes tincluding Practicals/Seminar/ iva-Voce,cte.).
CODE NO TITLE OF PAPERS
**************************f************************************************************************************************************************************************
********************** ***************************************************************************************************************************************
********************
******************* ***
*************** *******T**********
************************** *********************************************************************************************************************************************
***************************T*********************************************************************************************************************************************
** *****************************************************************************
**** ****************************************************
****** ** **************
************************** ***** *** * ************************************************************************************************************************
***********-** ******. ******************************* ****************************************************************************-********************* **********
****************************T************************************************************************************************************************************************
Backlog Papers (if any)
******************* ******************************************************************************************************************************************
****************************f***************************************************************************************** ******************************************************
**** ************** ************* **************
Permitted to appear in ( . . . . ...) pes. *******************************************
(Signature of the Candidate)
Dealing Assistant
et(Male) Datcd..***** ****************
(Examination) Righe (Fema
Datcd.... ******
- humb
ession
[Link] Controller
(Examinations)
Dated....*******