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 1. Name of Student (In block letter) *
2. Father’s Name*
3. Date of Birth *
MM
/
DD
/
YYYY
 4. College Roll.No *
 5. University Roll. No *
6. Course *
7. Branch* *
UNDERTAKING
I hereby undertake to attend Lecture /Tutorial/Practical classes regularly and to maintain more than 75% attendance in Class. I shall follow rules and regulation of the Institute.
 8. Student Email Addreess *
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