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DTE Details

DTE Application Id: ME18535085 DTE Course Name: M.Tech. Power Electronics
DTE Institute Name: Raipur Institute of
Technology, Chhatona,
Mandir Hasaud, Raipur

Current Enrollment Details

Application Seq No: 20185062045645 Institute Code: 012


Course Code: 5062 Institute Name: Raipur Institute Of
Technology - Raipur
Course Name: M Tech In ELECTRICAL Admitted Quota: C.G. QUOTA
(POWER ELECTRONICS)
Admitted Category: UR

Previous Enrollment at CSVTU Details

Have you Enrolled earlier for any course in CSVTU?: Yes


Previous Enrollment Number: AJ1783 Previous Enrollment Course: BE (Electrical and
Electronics)
Previous Enrollment Year: 2011 Previous Roll Number: 3412511031
Have you taken the migration certificate from CSVTU earlier?: Yes
Previous Migration Certificate Migration Issue Date: 10/Sep/2015
No.: CSVTU/15/34126

Admission Details

Course type: Direct Previous Enrollment Entry type: Full Time


Academic Year: 2018-2019 Name of the Programme: MTECH
Level/Semester/Year: Semester 1 Date of Admission: 01/Aug/2018

Personal Details

Full Name: SWETA GABHANE


Gender: Female
Mother's Name: SHARDA GABHANE
Father's Name: CHANDRA KUMAR GABHANE
Marital Status: Unmarried
Spouse Name:

Social Category: OBC


Social Category code: OBC
Do you belong to Physically Challenged category: No
Nationality: INDIAN

Date of Birth (DD/MM/YYYY): 27/Jun/1994


Age(As on 1 July 2017): 24
Aadhar Number: 992554676947
PIO Card Number:

Contact Details

Email ID: swetagabhane27@gmail.com Mobile Number: 9399960060


Area of Residence

Area of Residence: Urban

Permanent Address Details

House No./Street: B2/4 lokmanya housing Village/Town/Society: Raipur


society rohnipuram
Post Office/City: Raipur Country: India
Other Country:
State: Chhattisgarh Other State:
District: Raipur Other District:
Pincode: 492001

Address for Correspondence

Is your correspondence address same as Permanent Address?: Yes


House No./Street: B2/4 lokmanya housing Village/Town/Society: Raipur
society rohnipuram
Post Office/City: Raipur Country: India
Other Country:
State: Chhattisgarh Other State:
District: Raipur Other District:
Pincode: 492001

Social category Details

Caste Certificate No.: 2017-01-028725 Caste Certificate Issue date: 22/Sep/2017


Caste Certificate Issue State: Chhattisgarh Caste Certificate Issue Raipur

Qualifying Examination Details

Roll Number(Class X): English Subject Percentage:


Qualifying Examination Passed: BE Name of the Examination: BE(EEE)
Roll Number: 3412511031 State: CHHATTISGARH
Board/University: CHHATTISGARH SWAMI Other Board/University:
VIVEKANAND TECHNICAL
UNIVERSITY, BHILAI
(CHHATTISGARH)
Year of Passing of Qualifying Marks Obtained: 5436
Examination: 2015
Total Marks: 7000 Marks % in Last Exam: 77.66
S No. Subject Marks Obtained Maximum Marks Percentage
1 -
2 -
3 -
Total

Previous Examination Details

Is your previous examination details same as qualifying examination details?: Yes


Previous Examination Passed: BE Name of the Examination: BE(EEE)
Roll Number: 3412511031 State: CHHATTISGARH
Board/University: CHHATTISGARH SWAMI Other Board/University:
VIVEKANAND TECHNICAL
UNIVERSITY, BHILAI
(CHHATTISGARH)
Year of Passing of Previous Marks Obtained: 5436
Examination: 2015
Total Marks: 7000 Marks % in Last Exam: 77.66
Domicile Details

State: Chhattisgarh District: Raipur


Tehsil: RAIPUR

Migration Certificate Details from Other Board/University

Have you received the Migration Certificate from your other Board/University?: No
Migration Certificate Number: Migration Date:

Gap Details

Do you have any GAP in Educational Qualifications?: Yes


Duration From: 26/Jun/2015 Duration To: 01/Aug/2018

Fee Details

Enrollment Fee(in Rupees): 100


Immigration Fee (in Rupees) as applicable: 500
Total Fee(in Rupees): 600.0
Payment Transaction No.: NHMP6635447986

Declaration

I hereby declare that:


1) At Present I am not pursuing any other courses/Studies in any institute/university/board as a regular student.
2) I am not employed in any institute/organization/industry/any other place, discharging duties during class hours.

Signature of Applicant

Declaration By Principal

Certified that all the entries in the Enrollment Forms of the students of this Institute have been thoroughly checked through
the original documents submitted by the students.

Signature of Principal

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