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ISSUE OF ORIGINAL CERTIFICATE/DIPLOMA (This form should be duly filled in and submitted for issue of Certificate/Diploma) 1. 2. Name of the candidate (in block capital) : i) Name of the Examination passed for which the diploma/certificate is sought. ii) Year of Examinations (Annual/Supp.) : : 3. College from which appeared, as a Collegiate or Noncollegiate candidate. : 4. Roll No. in the Examination. : 5. Registration No. as student o.

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