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PERSONAL INFORMATION

FIRST NAME

MIDDLE NAME

LAST NAME

SEX

PWD

PWD TYPE

% OF DISABILITY

DATE OF BIRTH (DATE /MONTH /YEAR)

COMMUNICATION INFORMATION

PERMANENT ADDRESS

PRESENT ADDRESS TICK TO COPY PERMANENT ADDRESS aS PRESENT ADDRESS

PERMANENT PIN CODE

PERMANENT STATE

PRESENT PIN CODE

PRESENT STATE

PERMANENT COUNTRY

PRESENT COUNTRY

LOCALITY TYPE

NEAREST RAILWAY STATION

12^TH STANDARD INFORMATION

SCHOOL NAME (10+2)

BOARD ROLL NO (10+2)

REGN. NO. / ID / ENROLLMENT NO. (10+2)

REGISTRATION YEAR (10+2)

PASSING YEAR (10+2)

BOARD/COUNCIL (10+2)

UNIVERSITY REGISTERED

UNIV. REGISTER NO.

UNIV. REGISTER YEAR.

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	ENTER FULL MARKS		ENTER MARKS OBTAINED		%_MARKS
	THEORY	PRACTICAL/PROJECT	THEORY	PRACTICAL/PROJECT
ENGLISH
LANGUAGE
SUBJECT 1					*
SUBJECT 2					*
SUBJECT 3					*
SUBJECT 4
ENVIRONMENTAL STUDIES
Best 5 Total		Best of 5(%)

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MIDNAPORE COLLEGE (Autonomous)

Accredited by NAAC: Grade-A+ CGPA-3.60

Raja Bazar Main Rd, Medinipur, West Bengal, Pin:721101

Phone: 03222 275 847 E-Mail: mcm.principal@gmail.com Website: midnaporecollege.ac.in

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12^TH STANDARD INFORMATION

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MIDNAPORE COLLEGE (Autonomous)

Accredited by NAAC: Grade-A+ CGPA-3.60

Raja Bazar Main Rd, Medinipur, West Bengal, Pin:721101

Phone: 03222 275 847 E-Mail: mcm.principal@gmail.com Website: midnaporecollege.ac.in

PERSONAL INFORMATION

COMMUNICATION INFORMATION

12TH STANDARD INFORMATION

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12^TH STANDARD INFORMATION

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