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Chaudhary Charan Singh University, Meerut [ Computer Copy ]

Examination Form for "U.G. & P.G." Class, Session 2019-20

1. Course Applied For : B.Tech. (Electronics & Communication Engineering)

2. College Name : SIR CHHOTU RAM ENGG. INSTITUTE & TECH. CCS UNIV.
CAMPUS, MEERUT
3. Roll No. : 100160015 4. Enrolment No. : M-16307640
Form No:191030118
5. Semester : VIIth Semester 6. Type of Exam : Main Exam
7. Name of the Candidate : MOHD. MUFASSIL
8. Father`s Name : MUZEEBUR REHMAN
9. Mother`s Name : SHAHEEN BEGUM
10. Date of Birth : 11/06/1999 11. Sex : Male
12. Original Resident of : U.P. 13. Kashmiri Migrant : No
14. Caste : OBC (104)
15. State from where Graduated : U.P
16. Do you have Domicile Certificate of U.P. State : Yes
17. Permanent Address : DHAUNRA TANDA POST DHAUNRA DIST BAREILLY ,
BAREILLY, BAREILLY, Pin : 243202 Signature of Candidate
18. Present Address : DHAUNRA TANDA POST DHAUNRA DIST BAREILLY ,
BAREILLY, BAREILLY, Pin : 243202
19. Phone/Mobile No. : 7536853616
20. Email ID : MOHDMUFASSIL786@GMAIL.COM

21. Name of Subjects


S.No. Name of the Papers Code No.
1 Understanding the human being Comprehensively Human Aspiration audits fulfilment BT-701
2 Information Theory & Coding BT-702
3 Optical Communication BT-703
4 Data Communication Networks BT-704
5 VLSI Design BT-705
6 Optical Communication & Networking Lab BT-753
7 Electronics Circuit Design La BT-754
8 Industrial Training Viva-Voce BT-755
9 Project - I BT-756
10

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Course : B.Tech. (Electronics & Communication Engineering)
Semester : VIIth Type of Exam : Main Exam From No. : 191030118

22. Give details of marks obtained in previous examination Result


Part/Sem Roll No. Year Result Obtained Marks Maximum Marks
6 100160015 3RD YEAR PASS 735 1000
23. Description of Examination:
Name of Examination Year Name of the School/College Roll No. Mrks obt. Max. Mrks Division
Board/University Name
High School 2014 UP BOARD PATEL INTER 0973701 412 600 Ist
COLLEGE
DHAUNRA
BAREILLY
Intermediate 2016 UP BOARD PATEL INTER 0772107 305 500 Ist
COLLEGE
DHAUNRA
BAREILLY
Graduation
Post Graduation
24. Name of the Class : Punishment Details :
Roll No : Year : Name of Centre :
25. If last examination passed from other university give the details of migration certificate from that university :
26. If you are employed , give the details of "No Objection Certificate" :
27. If Migration certificate is enclosed from another university/Board. mention its no. & date :
28. Participation in Sports:- Level of Game/Sports :
29. Checklist (Attached Documents)
Marksheet of High School : Yes Marksheet of Intermediate : Yes Marksheet of Graduation : Yes
Marksheet of Post Graduation : No Residence/Domicile Certificate : Yes Handicap Certificate : No
Caste Certificate :Yes Bank Challan : Yes Migration Certificate : No
No objection certificate : No
Any other certificate 1. 2.
Declaration
I MOHD. MUFASSIL(191030118) hereby declare that I have read the eligibility conditions given in Information Brochure very carefully and I undertake
the responsibility of fulfilling eligibility conditions. The entries in the form are correct to the best of my knowledge and belief. If any entry is found to be
wrong or false, my admission may be cancelled at any time. I will pay all dues in accordance with the University rules and regulations and also abide
by the rules of conduct, behavior and studies

Detail of Examination Fee


Total Fees : 1170
Transaction No. : 2070012064
Date : 24/10/2019
Payment Status : PAID

Date:___________________

Place:___________________ (Full Signature of the Applicant)

Certidicate of the Principal


All the entries in the exam from, marksheets and other certificates attached have been duly checked and this is certified
that he/she is eligible for examinatio as per university rule and his/her examination form is being forworded.

Date:___________________

Sign of the checker :___________________ (Full Signature of the Principal with stamp)

Page 2/4
Chaudhary Charan Singh University, Meerut [ University Copy ]
Examination Form for "U.G. & P.G." Class, Session 2019-20

1. Course Applied For : B.Tech. (Electronics & Communication Engineering)

2. College Name : SIR CHHOTU RAM ENGG. INSTITUTE & TECH. CCS UNIV.
CAMPUS, MEERUT
3. Roll No. : 100160015 4. Enrolment No. : M-16307640
Form No:191030118
5. Semester : VIIth Semester 6. Type of Exam : Main Exam
7. Name of the Candidate : MOHD. MUFASSIL
8. Father`s Name : MUZEEBUR REHMAN
9. Mother`s Name : SHAHEEN BEGUM
10. Date of Birth : 11/06/1999 11. Sex : Male
12. Original Resident of : U.P. 13. Kashmiri Migrant : No
14. Caste : OBC (104)
15. State from where Graduated : U.P
16. Do you have Domicile Certificate of U.P. State : Yes
17. Permanent Address : DHAUNRA TANDA POST DHAUNRA DIST BAREILLY ,
BAREILLY, BAREILLY, Pin : 243202 Signature of Candidate
18. Present Address : DHAUNRA TANDA POST DHAUNRA DIST BAREILLY ,
BAREILLY, BAREILLY, Pin : 243202
19. Phone/Mobile No. : 7536853616
20. Email ID : MOHDMUFASSIL786@GMAIL.COM

21. Name of Subjects


S.No. Name of the Papers Code No.
1 Understanding the human being Comprehensively Human Aspiration audits fulfilment BT-701
2 Information Theory & Coding BT-702
3 Optical Communication BT-703
4 Data Communication Networks BT-704
5 VLSI Design BT-705
6 Optical Communication & Networking Lab BT-753
7 Electronics Circuit Design La BT-754
8 Industrial Training Viva-Voce BT-755
9 Project - I BT-756
10

Page 3/4
Course : B.Tech. (Electronics & Communication Engineering)
Semester : VIIth Type of Exam : Main Exam From No. : 191030118

22. Give details of marks obtained in previous examination Result


Part/Sem Roll No. Year Result Obtained Marks Maximum Marks
6 100160015 3RD YEAR PASS 735 1000
23. Description of Examination:
Name of Examination Year Name of the School/College Roll No. Mrks obt. Max. Mrks Division
Board/University Name
High School 2014 UP BOARD PATEL INTER 0973701 412 600 Ist
COLLEGE
DHAUNRA
BAREILLY
Intermediate 2016 UP BOARD PATEL INTER 0772107 305 500 Ist
COLLEGE
DHAUNRA
BAREILLY
Graduation
Post Graduation
24. Name of the Class : Punishment Details :
Roll No : Year : Name of Centre :
25. If last examination passed from other university give the details of migration certificate from that university :
26. If you are employed , give the details of "No Objection Certificate" :
27. If Migration certificate is enclosed from another university/Board. mention its no. & date :
28. Participation in Sports:- Level of Game/Sports :
29. Checklist (Attached Documents)
Marksheet of High School : Yes Marksheet of Intermediate : Yes Marksheet of Graduation : Yes
Marksheet of Post Graduation : No Residence/Domicile Certificate : Yes Handicap Certificate : No
Caste Certificate :Yes Bank Challan : Yes Migration Certificate : No
No objection certificate : No
Any other certificate 1. 2.
Declaration
I MOHD. MUFASSIL(191030118) hereby declare that I have read the eligibility conditions given in Information Brochure very carefully and I undertake
the responsibility of fulfilling eligibility conditions. The entries in the form are correct to the best of my knowledge and belief. If any entry is found to be
wrong or false, my admission may be cancelled at any time. I will pay all dues in accordance with the University rules and regulations and also abide
by the rules of conduct, behavior and studies

Detail of Examination Fee


Total Fees : 1170
Transaction No. : 2070012064
Date : 24/10/2019
Payment Status : PAID

Date:___________________

Place:___________________ (Full Signature of the Applicant)

Certidicate of the Principal


All the entries in the exam from, marksheets and other certificates attached have been duly checked and this is certified
that he/she is eligible for examinatio as per university rule and his/her examination form is being forworded.

Date:___________________

Sign of the checker :___________________ (Full Signature of the Principal with stamp)

Page 4/4

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