CENTRAL UNIVERSITY OF HARYANA
End-Semester Examination, ………………………………………………
EXAMINATION FORM
(TO BE FILLED IN ENGLISH IN BLOCK LETTERS ONLY)
REGISTRATION NO.
ROLL NO.
(For Office Use Only, Not to be filled by the Candidate)
PROGRAMME SEMESTER
1. Name of Candidate
2. Father’s Name
3. Mother’s Name
4. Date of Birth 5. Sex Code
6. Address

State Urban(U)/ Rural(R)
Mob. No. Email
7. SC/ST/OBC/Handicapped (H)
8. Courses Offered
Sr. No. Course Nomenclature Course Code
Core Courses
1
2
3
4
5
6
 
Sr. No. Course Nomenclature Course Code
Elective Courses
1
2
3
4
5
6

9. Details of examinations already qualified
Name of Exam Name ofBoard/University Year/
Session Roll No. Subjects Result

10. Whether simultaneously appearing in any other examination of this or any other University– Yes/ No
11. I solemnly declare that the particulars filled in by me are correct and nothing has been concealed and that in case of any discrepancy found therein, I shall be responsible for the consequences.
Date:
Place: Signature of the Candidate
ATTESTATION
Certified that the candidate has completed the requirements as laid down in the rules for the above mentioned class under University Roll No………………. as a regular student and is eligible to appear in the examination.He/She bears a good moral character and has signed this form in my presence.

Date: Signature of the concerned/
Place: Authority/Faculty (with office seal)

Checked by the University Official Clerk….………………. Assistant…………………………..
CENTRAL UNIVERSITY OF HARYANA
ROLL NO. SLIP (Student Copy)
(TO BE FILLED IN ENGLISH IN BLOCK LETTERS ONLY)
REGISTRATION NO.
ROLL NO.
(For Office Use Only, Not to be filled by the Candidate)
PROGRAMME SEMESTER
1. Name of Candidate
2. Father’s Name
3. Mother’s Name
4. Address

State Urban(U)/ Rural(R)
5. Handicapped (PH/Vs)
6. Courses Offered
Sr. No. Course Nomenclature Course Code Core (C)/ Elective (E)
1
2
3
4
5
6
7
8
9
10

Signature of issuing authority

CENTRAL UNIVERSITY OF HARYANA
ROLL NO. SLIP (Office Copy)
(TO BE FILLED IN ENGLISH IN BLOCK LETTERS ONLY)
REGISTRATION NO.
ROLL NO.
(For Office Use Only, Not to be filled by the Candidate)
PROGRAMME SEMESTER
1. Name of Candidate
2. Father’s Name
3. Mother’s Name
4. Address

State Urban(U)/ Rural(R)
5. Handicapped (PH/Vs)
6. Courses Offered
Sr. No. Course Nomenclature Course Code Core (C)/ Elective (E)
1
2
3
4
5
6
7
8
9
10

Signature of issuing authority