b 122 s 78 Applicationform

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b 122 s 78 Applicationform

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  • (Enrolment ID)B122S78

    Zone/Scrutiny

    Payment DetailsRs. 1500.00

    3GE

    (D.O.B)

    Qualification Details (Exam City 1)

    Amitesh Kumar(Full Name of the Applicant)

    07 May 1995 Male

    Indian National

    GEN No

    B.Tech

    Ravindra Singh

    Haryana 121006

    YMCA UST

    Communication Address

    Graduated: No; Year of Graduation: 2016Electrical Engg./Electrical and Electronics Engg.

    I hereby declare that all the particulars stated in this application form are true to the best of my knowledge andbelief. I have read the Information Brochure and I shall abide by the terms and conditions therein. Theresponsibility of following the GATE 2016 website and meeting various deadlines lies with me. In the event ofsuppression or distortion of any fact in my application form, I understand that I will be denied the opportunityto appear in GATE 2016. Further, if any suppression or distortion of facts is found after appearing in theexam, any admission/degree/benefit acquired on the basis of GATE 2016 score/marks is liable to becancelled.

    DigitalFingerprint:

    OnlinePayment Ref. No.: CP29099462

    C/O- A.K Singh, Shivalaya LaneEast LohanipurKadamkuanPatnaBihar 80000388022 39351 (Mobile No.)[email protected]

    Zonal GATE Office ContactChairperson GATE

    Hauz Khas, New Delhi 110016

    6ba064a42443f871d82f990bcad0deea

    GATE Exam Details

    (Exam City 2)

    19/09/2015

    FARIDABAD

    GATE 2016

    (Exam City 3)

    (Gender) (Category) (PD Status)

    GATE Paper Code

    9973143709

    EENew Delhi , DL

    Gurgaon , HR

    Faridabad , HR

    Indian Institute of Technology Delhi

    (Parent's Mobile Number) (Name of the Parent)

    B122S78

    (Electrical Engineering)