(Speed Post)

No.: IIT/Acad(PGS&R)/M. Tech/Offer/2014-2016/2014114513046

Dated: 13-06-2014
To
MANCHALA SUDHAKAR REDDY
H.NO 1-114,KOTAPADU
VILLAGE,KOLIMIGUNDLA
MANDAL
KURNOOL DIST, ANDHRA
PRADESH, Pin : 518166.
Sub : Provisional offer of admission to the Joint M.Tech/MCP - PhD Programme 2014
Course Offered: CH(CHEMICAL ENGINEERING)
Dear MANCHALA SUDHAKAR REDDY
In continuation to our earlier communication to you on the above-mentioned subject, please note that the Registration for the
above programme is scheduled to be held on July 14, 2014. You are required to report at 9.00 a.m. on July 14, 2014 in the Kalidas
Auditorium located in the Vikramshila Complex of the Institute for welcome address and registration.
At the time of registration, you will be required to produce (a) ORIGINAL GATE SCORE CARD (b) original certificates
and mark-sheets of your educational qualifications, (c) evidence of the work experience, if any, (d) category certificate
(OBC(NCL)/SC/ST/PwD), if applicable, issued by competent authority as mentioned overleaf, (e) If you are in employment, you
must resign and produce the acceptance of your resignation by the employer at the time of joining. Please note that a set of attested
copy of each of these documents is necessary for our records. The originals will be returned to you after verification.
Candidates must have a minimum of 60% marks (or a CGPA of 6.5 in 10 point scale) in the final qualifying examination for
GE/OBC categories and 55% marks (or a CGPA of 6.0 in 10 point scale) for SC/ST/PwD categories. In case you are not in a
position to produce the original degree certificate/mark-sheet on the registration date, you must provide course completion
certificate from the principal (Annexure-1). Your registration is liable to be cancelled if you fail to produce your degree
certificate by October 31, 2014.
Please also find enclosed necessary forms that you have to submit, duly filled in, at the time of registration
The mode of payment of fees is available on ERP home page (https://erp.iitkgp.ernet.in) under the heading Instructions to all
Freshers. In addition to the amount of Rs. 15,000.00 (Rupees Fifteen thousand) paid by you as advance, you are required to pay the
following amount preferably before July 2, 2014:
For GE/OBC candidate - Rs. 22,781/-
For SC/ST candidate - Rs. 17,781/-
Prior to joining, you should fill your personal information via the Institute ERP System, which will include the following:
1. Information related to generation of electronic identification card (smart card), which will give you access to library, laboratory,
attendance and hospital.
2. IIT provides E-mail to each and every student. Please give your choice of login ID for E-mail.
3. Your medical history and medical report with supporting documents as instructed has to be uploaded on to the online system after
scanning the documents. The hardcopies of the documents have to be submitted at the time of registration.
4. Upload image files of the photograph and signature while updating your profile (if not already uploaded).
5. After your registration process is complete on the date of joining, please go to your respective departments for further instruction.
The instructions for logging into the Institute ERP System will be found in detail in the attached document 'Admission Procedure of
Students through ERP System'.
Please try to reach the Hall of Residence by 13th July 2014, preferably between 9.00 a.m. and 9.00 p.m. On arrival, please
contact the Manager/Caretaker of the Hall for doing the needful.
Looking forward to meet you at IIT Kharagpur.
Yours sincerely,
Assistant Registrar (PGS&R)
INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR
ACADEMIC (PGS&R) SECTION
Encl. : 1. Format of Certificate from the Principal
2. Medical Fitness Certificate Form
3. Students/Guardians Undertaking
The authorities empowered to issue Other Backward Class/ Scheduled Caste / Scheduled Tribe are:
1) District Magistrate / Additional District Magistrate / Collector / Deputy Collector / Deputy Commissioner / Additional
Deputy Commissioner / 1st Class Stipendiary Magistrate / City Magistrate / Sub-Divisional Magistrate / Taluk Magistrate /
Executive Magistrate / Extra Assistant Commissioner.
2) Chief Presidency Magistrate / Additional Chief Presidency Magistrate / Presidency Magistrate.
3) Revenue Officer not below the rank of Tahsildar.
4) Sub-Divisional Officer of the area where the candidate and/or his family normally resides.
5) Administrator / Secretary to Administrator / Development Officer (Lakshadweep Islands).
THE CERTIFICATE ISSUED BY ANY OTHER OFFICIAL WILL NOT BE ACCEPTED.
FOR OBC (NCL), THE CERTIFICATE SHOULD BE ISSUED ON OR AFTER 1st APRIL, 2013.
INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR
ACADEMIC (PGS&R) SECTION
Annexure-1
FORMAT OF CERTIFICATE FROM THE PRINCIPAL
Date :..........................
Name of the Candidate: ....................................................................................................................
I understand that Mr. / Ms. .........................................................................................................................
is admitted to the M.Tech./MCP 2014 Programme at Indian Institute of Technology Kharagpur. This is to certify that the
candidate belonging to ...............................................................................
............................................................................. Department / Specialisation of ................................................
this Institution has completed all parts of the examination for the award of degree of..............................................
................................................................................ by.....................................................................................................
(BE., B. Tech./etc.) (date)
(Seal of the Institution)
.........................................................
Signature of the Principal/Head
of the Institution with date
INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR
ACADEMIC (PGS&R) SECTION
CONFIDENTIAL
MEDICAL HISTORY AND PERSONAL PARTICULARS OF STUDENTS
JOINING IIT KHARAGPUR
1.Full Name (in capitals) .....................................................................................................................
2.Roll No......................................................................................................................................
3.Name of Parent / Guardian .................................................................................................
4.Personal : Veg. / Non-Veg
Abuse of substances (if any) : Smoking / Alcohol / Drugs / Any Other
5.Past Medical / Surgical Treatment (Please Tick) : No Yes
2.1 Allergies / Bronchial asthma / Tuberculosis ..... .....
2.2 Abdomen including Urinary Tract ..... .....
2.3 Locomotor System (Spinal/Vertebral column/Joints) ..... .....
2.4 Cardiovascular system ..... .....
2.5 Neurological disorders / Psychological disorders ..... .....
2.6 Sexually-transmitted / Venereal Diseases / Skin ..... .....
2.7 Hepatitis ..... .....
2.8 Diabetes ..... .....
2.9 Rheumatism ..... .....
2.10 Thyroid disease ..... .....
6.Family history of any major illness (Please Tick) : No Yes
3.1 Tuberculosis ..... .....
3.2 Leprosy ..... .....
3.3 Diabetes ..... .....
3.4 Hypertension ..... .....
3.5 Ischemic heart diseases ..... .....
3.6 Psychiatric illness ..... .....
3.7 Cancer ..... .....
7. Identification Marks : 1)
2)
8. Blood group :
I declare that all the statements above are true and correct to the best of my knowledge. I fully understand that I am
responsible for the accuracy of all statements given.
Candidates Signature
Counter signed by Parent / Guardian :
Date :
Place :
INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR
ACADEMIC (PGS&R) SECTION
HEALTH CERTIFICATE
1. Examination by a General Physician (M.D. in General Medicine)
I, Dr.
After examining (with necessary investigations) Mr./Ms.
..Son/Daughter of Mr./Ms. . Born on
..
CERTIFY :
Weight ..kg. Height .cm. Blood pressure ./ mm Hg.
Girth of Chest: (a) At rest . (b) After deep inspiration .
Cardiovascular System:Heart . Heart Sounds
Respiratory System:
Neurological System:
Psychological disturbance:Yes / No If yes, specify
Past Medical or surgical Record:
Identified allergies :
Current treatments:
Current Vaccination Status (All candidates who do not have adequate active / passive immunity against diseases
mentioned below should take these injections/adult booster dose as recommended, just before joining the Institute and the
date to be mentioned below).
VACCINATION AGAINST DISEASES 1st Injection Last Booster
Date Yes / No Date Yes / No
BCG
Diphtheria Tetanus - Poliomyelities
Measles, Mumps, Rubella
Hepatitis B
Hepatitis A
Meningitis
Typhoid
Chicken Pox
Candidates Signature : .....................
INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR
ACADEMIC (PGS&R) SECTION
INVESTIGATIONS
1. *Electrocardiogram Date Result
2. *Chest X-ray Date .. Result
3. *Sonography (whole abdomen) Date .. Result
4. *Urine Date .. Result
5. *Blood Tests
a) Blood Sugar (F/PP) Date .. Result
b) Urea/Creatinine Date .. Result
c) Peripheral Smear Study /HB% Date .. Result
d) Lipid Profile Date .. Result
e) Blood group/ typing (if not known) Date .. Result
f) HBS Ag Date .. Result
g) HIV I & II Date .. Result
*All original investigation reports to be attached.
Remarks/ Special Recommendation, if any :
Conclusion : Fit/ Unfit to pursue higher education with a very tight academic schedule.
Reason :
Date : Signature and Seal
Place :
Candidates Signature : ..............................
INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR
ACADEMIC (PGS&R) SECTION
2. Examination by Ophthalmologist*
Acuity of Vision Far Vision Near Vision Colour Vision
Naked eye With glasses Naked eye With glasses
R.E.
L.E.
*Latest Optometrists Recommendations if any to be attached in original
Remarks /Special recommendation, if any
I, Dr. .............................
Have examined ( with necessary investigations) Mr./ Ms. .....................
..Son/Daughter of Mr./Ms........................
Born on .................. and the above information given to the best of my
Knowledge are correct and true.
Date : Signature and Seal
Place :
3. Examination by ENT Specialist*
Inspection / hearing *Audiometry
Right Ear
Left Ear
* Latest Audiometry report to be attached in original
Remarks / Special recommendation, if any
I, Dr. .................
Have examined ( with necessary investigations) Mr./ Ms. .................
..Son/Daughter of Mr./Ms...............
Born on ...... and the above information given to the best of my
Knowledge are correct and true.
Date : Signature and Seal
Place :
Candidates Signature : ............................
INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR
ACADEMIC (PGS&R) SECTION
Undertaking from the Student & Guardian
I, Mr./Ms. ........................................................................................................, Roll No.:
...........................................................................
Program:
..............................................................................Dept..........................................................................................Student of
Indian Institute of Technology Kharagpur do hereby undertake on this
day..................................month..................................................
year .................................., the following :
1. I shall abide by the admissible rules and regulations of IIT Kharagpur and follow the code of conduct for students. I
acknowledge that the institute has the authority of taking disciplinary action on me for non-compliance of the same.
2. That I have read and understood the directives of the Hon'ble Supreme Court of India on anti-ragging
(available at http://www.iitkgp.ac.in/dosa/)
3. That I understand the meaning of Ragging and know that ragging in any form is a punishable offence and the same
is banned by the Court of Law. I undrastand that, in case I am involved in ragging , the case will be reported to the
police and the Law will take its own course and I will be summarily expelled from the institute.
4. That I have not been found or charged for my involvement in any kind of ragging in the past. However, I undertake
to face disciplinary action / legal proceeding including expulsion from the institute if the above statement is found
to be untrue or the facts are concealed, at any stage in future.
5. That I shall not resort to ragging in any from at any place and shall abide by the rules/laws prescribed by the Courts,
Goverment of India and Institute authorities for the purpose from time to time.
6. I understand that as per rules and resolution of the Institute, I will not be permitted to possess or use any motorised
vehicle inside the Institute campus, unless I am permitted to do so by a written authorisation from the Dean
(Student's Affairs).
7. I declare that I am not suffering from any serious/contagious ailment including psychology related symptoms. I also
understand that the medical examination report submitted by me is only for provisional offer of admission and this
provisional admission may be cancelled if the Medical Fitness Test conducted by the Institute finds me to be
medically unfit.
7. I acknowledge that the institute has the authority to place a student on Mandatory Medical Leave of Absense if a
student is found to be in a mental or physical condition leading to his/her inability to function on campus in an
independent manner that includes taking required medications unsupervised due to an incapacitating medical
condition.
Signature of Student
I hereby fully endorse the undertaking made by my child / ward.
Signature of Mother / Father and or Guardian
INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR
ACADEMIC (PGS&R) SECTION