TASK STUDENT REGISTRATION PROBLEM FORM

Univ_Hallticket: B14EC102
First_Name:CHOUTI

Middle_Name:

Date_Birth(dd/mm/yy): 27/12/1996
Category: OC

Last_Name: SAMBASHIVA

Gender: male

Religion: HINDU

Amount Paid: 00

Aadhar_Number: 763013975342

Parent_Name: CHOUTI LAXMANAMURTHY

Parent_Mobile: 9948115755

Parent_Profession: PUROHITH

Annual_Income:

84000

Address: H. No: 2-10-1873

Street: BHAGYANAGAR

Village: KARIMNAGAR

District:KARIMNAGAR

State: TELANGANA

Mobile: 8897825755

Mandal:KARIMANAGAR
Pincode: 505001

Email id: sambashivasharma96@gmail.com

Alternate Email:sambashivachouti@gmail.com
Qualification:BTECH 3 YEAR
Course
SSC:
INTER
Dipoloma
B. Tech:
Semester
SEM-1:
SEM-2:
SEM-3:
SEM-4:
SEM-5:
SEM-6:

Branch: ECE Passing_Year:2018

Passing_year
2012
2014

Total_marks
10
1000

Passing_year
2015
2015
2015
2016

Total_marks
10
10
10
10

Any Educational Gaps (Y/N): No

Obtained_marks
9.7
962

Obtained_marks
9.7
9.5
8.9
10

Percentage
97
96.2

Percentage
97
95
89
100

Gap_Years: NO

Gap_Reason:
Any_backlogs(Y/N): No.
Transaction Amount: 00

Number_of_backlogs:
Trans. Date:

Trans_Reference No:

Declaration: The above details given by me are true to the best of my knowledge.

Date:28/09/2016

Signature:SAMBASHIVA