Biodata

 

Full Name of Batch mate .......................................................................... ...................................................

College Roll No. ...................

Qualification ................... .....Speciality / Personal Assignment ................... ...................................................

Date of Birth ................... .............Achievements ....................................................................... ....................

Address :     Clinic ................... ......................................................................................................................

                    Resident ............................................................... .....................................................................

Contact Telephone Numbers:

E mail address                     :

Spouse ................... Qualification ................... Speciality / Personal assignment / Achievement ..........................

Date of Birth ..............................

Children with Age / Date of Birth ................... ................... ............................................................................

Studying in class ................... .........................................................................................................................

Achievements ................................................................................................................................................

Whether willing to participate in cultural programme Yes / No. Mention Details if Yes ................... ...................

 

Food :Veg / Non-veg.

Suggestions ................... ................................... ................................... ..........................................................

 

 

Please send completed Biodata with cheque / DD for Rs 5000 in favour of ' Silver Jubilee 77, G.M.C. Nagpur" payable at Nagpur & Family Photograph to Dr. Krishna Parate Organizing Secretary, 18 Hindustan Colony, Opp. Sai Mandir Wardha Rd. NAGPUR 440015. Phone 232118

e-mail : kmparate@nagpur.dot.net.in.

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