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Mber / Roll Number 3. Student Name 4. Date of Birth 5. Father/Guardian Name 6. Department 7. Course type Research Scholar / PG / UG Students Please ( ) your course type 8. Year/Semester 9. Student E-mail 10. Student Mobile Number 11. Old MAC Address (of Laptop) 12. New MAC Address (of Laptop) 13. Resident of (Name of Hall) / NRSC Student Declaration I hereby confirm and certify that the above information is correct to the.

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