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Registration No: 1020849

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4/13/2015

RegistrationNo:1020849

1.QualifyingDegree

: BE/BTECH(REGULAR)

Photo

2.SpecializationinQualifying
Degree

: CSE/COMPENG

3.TestsappearinginPGECET

: ComputerScience&InformationTechnology

4.Centerforappearingthetest : Vishakapatnam

5.CandidateDetails
MADDULASANTOSH
Candidate'sName
:
KUMAR

6.Category

7.SeekingAdmissionunderSpecial
Category

SSC(10thClass)Hall
TicketNumber

: 1296649

SSCPlaceofStudy

: Urban

Father'sName

: MADDULACHITTIBABU

DateofBirth

: 18/9/1992

Gender

: Male

MotherName

: MADDULAVIJAYALAXMI

AadharNumber

: 474352037901

AnnualIncomeofthe
Parentsin(Rs)

10.StudyDetails

Signature

:OC

NCC
CAP
Sports
Physically
Challenged

: No
: No
: No
: NON

8.LocalAreaStatus

:AU

9.Minority

:None

: BelowOneLakh

Class4

: Vishakhapatnam

Class5

: Vishakhapatnam

Class6

:Vishakhapatnam

Class7

: Vishakhapatnam

Class8

: Vishakhapatnam

Class9

:Vishakhapatnam

Class10

: Vishakhapatnam

: Vishakhapatnam

B.Tech/B.Pharm:Vishakhapatnam

Inter/
Diploma

MCA/
:
M.Sc/Others

11.AddressforCorrespondence
1042,OppGVMCOUT
GATE

HouseNo./C/O

Street/Locality
/Village

: RAMNAGAR

PinCode

: 530002

ContactTelephone
Number(mobile)

: 9000677991

Mandal/Town/City : VISAKHAPATNAM

TelephoneNumber
(Landline)

District

Email

: VISAKHAPATNAM

: santoshkumar.maddula3@gmail.com

Declaration:IhavecarefullygonethroughtheinformationbookletandIamconversantandshallabidebytheeligibility
conditionsandotherregulationstobesatisfiedforappearingattheentrancetestandadmissionintoanycourseprescribed.
Further,IassurethatIwillnotinvolveinanymalpracticeorillegalactivityintheentrancetest.Incase,Ihavefurnishedany
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4/13/2015

falseinformationorinvolvedinanymalpracticeorillegalactivity,Iknowthat,Iamliableforcriminalactionasperthe
existinglaw.

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