Safari
Safari
Full Name (as on 10th) Mrs MUHAMMED SHAMMAS Application Number 20240110369
ABC ID 473-405-418-284 DEB ID
Email [email protected]
10 digit Indian Mobile no. 9741850396
Relationship with
Parent / Guardian Name Jalauddin abdul khader Father
Applicant
Date of Birth
Gender Male 18/12/2005
(dd/mm/yyyy)
Marital Status Unmarried Religion Islam
Caste Muslim Category OBC
Differently Abled No Employment Status Unemployed
Communication Address Permanent Address
Darussalam, Awakhif coloney, Kinnikambla PO Mangalore Darussalam,Awakhif coloney ,
Pin: 574151 Kinnikambla PO Pin: 574151
State Karnataka State Karnataka
District Mangalore District
LSGD DETAILS
Local Body , Ward
QUALIFICATION DETAILS
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Qualification & Year & month of Passing Institution Percentage
Specialization
Tenth Level 2022 CBSE 60
Higher Secondary / Plus
2024 Scole kerela 70
Two / Pre Degree / V H S E
IDENTIFICATION DETAILS
ID Proof Type Not Updated ID proof Number Not Updated
DOCUMENTS UPLOADED
OTHER DOCUMENTS
PHOTO SIGNATURE
UPLOADED
DECLARATION BY APPLICANT
I hereby declare that all the particulars given above are correct and I agree to abide by all the Rules
and Regulations of the University that are in force from time to time.
Station:
Date:
Signature of Applicant
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FOR OFFICE USE ONLY
1. The particulars furnished in the application have been duly verified with Originals and the
Candidate is eligible for admission
2. Admission / Cancellation Intimation given / sent on ........................................................
3. Certificates returned to the Candidate on ......................................................................
1. S.S.L.C Statement of Marks
2. HSC Statement of Marks /Diploma Statement of Marks
3. UG Statement of Marks / Provisional/ Degree
Verified By RC Director
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