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Thapar University, Patiala: Name of Company Branch / Specialisation: (Ug / PG) Ug

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NAME OF COMPANY BRANCH / SPECIALISATION:

(UG / PG) UG

THAPAR UNIVERSITY, PATIALA


(Formerly known as Thapar Institute of Engg. & Tech.) (Established under section 3 of UGC Act, 1956 vide notification # F-12/84-U.3 of Government of India)

NAME : BRANCH : ROLL NO. : YEAR OF PASSING OUT:

MECHANICAL ENGINEERING DEPARTMENT(MED) THAPAR UNIVERSITY PATIALA-147004


1

PERSON AL INFORM ATION


Full Name in Block .Letters Date of Birth Age Citizenship Gender Correspondence .Address Paste Your Recent Passport Size Photograph

Telephone Numbers Permanent Address

Telephone Numbers

E-mail ID Fathers/Guardians Name & Occupation Mothers Name & Occupation

Languag eee English Hindi Punjabi

Understand ( / X)

Speak ( / X)

Read ( / X)

Write ( / X)

ACADEMIC RECORD: Univ./Board Examination Passed Class X Class XII Diploma

Year of Passing

Maximum Marks

Marks Obtained

%age

Division

BACHELOR OF ENGINEERING (BE/B.TECH), GRADUATION: Univ./Board Examination Year of Maximum Marks/CGPA CGPA/ Division Passed Passing Marks/CGPA Obtained %age 1st Semester 2006 2nd Semester 3rd Semester 4th Semester 5th Semester 6th Semester 7th Semester 8th Semester MASTER OF ENGINEERING (ME/M.TECH/MCA/M.Sc.): Univ./Board Examination Year of Maximum Marks/CGPA CGPA/ Division Passed Passing Marks/CGPA Obtained %age 1st Semester 2nd Semester 3rd Semester 4th Semester 5th Semester 6th Semester Latest CGPA till last result Declared ACADEMIC ACHIEVEMENTS: B.E/B.TECH M.E/M.TECH/MCA/M.Sc. THAPAR UNIVERSITY 2007 2007 2008 2008 2009

S UMME R T RA I NI NG / P RO JE CT SEME S T E R UNDE RTA K E N:


\

E XT RA CURRI CUL A R A CT I V IT IE S :

O T HE R I NFO RMA T I O N:

I hereby declare that the particulars given herein are true and complete to the best of my . knowledge and belief.
Place: Date: Signature:

. ..

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