bio data form final(bme)

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  • 7/28/2019 Bio Data Form Final(Bme)

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    Student Profile - BiomedicalBatch:

    VINAYAKA MISSIONS UNIVERSITY

    Vinayaka Missions Kirupananda Variyar Engineering

    College

    SALEM 636 308

    Programme B.E. (BIOMEDICAL ENGINEERING)Purpose Profile

    Please attach a

    color

    photograph

    that has been

    taken within

    the last 3

    months

    Name of the StudentRegister Number

    Student Mobile NumberBatchName of the Tutor Ward

    Tutor Ward Designation

    GENERAL

    Date of Birth( Day/Month / Year )

    Height(cms)

    Gender Male / Female

    Weight (kg)

    Identification Marks 1) 2)

    Student E-mail ID Blood Group

    Nationality Religion

    Caste Community

    Fathers Name Occupation

    Mothers Name Occupation

    Fathers MobileNumber

    Phone (Res)

    Fathers E-mail ID

    Guardians Name E-mail ID

    Guardians MobileNumber

    Occupation

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    Student Profile - BiomedicalBatch:

    ADDRESS FOR COMMUNICATION

    Permanent Address

    Student MobileNumber

    (Permanent) :

    _________________________________________________________________________

    _________________________________________________________________________

    _________________________________________________________________________

    _________________________________________________________________________

    _________________________________________________________________________

    _________________________________________ PIN

    Present Address

    Student MobileNumber

    (TamilNadu) :

    _________________________________________________________________________

    _________________________________________________________________________

    _________________________________________________________________________

    ________________________________________________________________________

    _________________________________________________________________________

    _________________________________________ PIN

    Guardian Address_________________________________________________________________________

    _________________________________________________________

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    Student Profile - BiomedicalBatch:

    ________________

    _________________________________________________________________________

    _________________________________________________________

    ________________

    _________________________________________________________________________

    _________________________________________ PIN

    EDUCATIONAL QUALIFICATIONS

    Secondary And / Or Hig h er Seconda ry

    Examination

    Board / InstitutionYear ofPassing

    Marks

    Obtained

    Out of(Total)

    %

    S.S.C. orEquivalent

    H.S.S.C. orEquivalent

    Diploma

    Examination BoardYear ofPassing

    % ofMarks

    Class awarded

    1s Sem.

    2nd Sem. Dip.

    3rd Sem. Dip.

    4th Sem. Dip.

    5 Sem.

    6 Sem.

    Under Gra d uation

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    Student Profile - BiomedicalBatch:

    ExaminationTotal Actual

    Marks

    TotalAcquire

    % ofMarks

    Year ofPassing

    Class awarded

    1st Sem. B.E

    2nd Sem. B.E

    3 rd Sem. B.E

    4 th Sem. B.E

    5th Sem. B.E

    6th Sem. B.E

    7th Sem. B.E

    8th Sem. B.E

    Over All Percentage

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    Student Profile - BiomedicalBatch:

    SEMESTER WISE INDIVIDUAL SUBJECT MARK DETAILS

    FIRST YEAR

    Subject Name Subject Year of Passing Marks

    Percentag Total Acquired Marks

    THIRD SEMESTER

    Subject Name Subject Year of Passing Marks

    Percentag Total Acquired Marks

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    Student Profile - BiomedicalBatch:

    FOURTH SEMESTER

    Subject Name Subject Year of Passing Marks

    Percenta Total Acquired Marks

    FIFTH SEMESTER

    Subject Name Subject Year of Passing Marks

    Percenta Total Acquired Marks

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    Student Profile - BiomedicalBatch:

    SIXTH SEMESTER

    Subject Name Subject Year of Passing Marks

    Percentage Total Acquired Marks

    SEVENTH SEMESTER

    Subject Name Subject Year of Passing Marks

    Percenta Total Acquired Marks

    EIGHTH SEMESTER

    Subject Name Subject Year of Passing Marks

    Percenta

    geTotal Acquired Marks

    COLLEGE RELATED DETAILS

    Date of Joining( Day /Month / Year )

    Yearly Tuition Fee 1) 2) 3) 4)

    Other Fee 1) 2) 3) 4)

    Yearly Hostel Fee 1) 2) 3) 4)

    Library Account Monthly Mess Fee

    Hostel Room

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    Student Profile - BiomedicalBatch:PLACEMENT PARTICULARS

    OFFERS RECEIVED:

    Company Name :

    Location :

    Designation :

    Salary per Annum :

    Date of Joining :

    ON CAMPUS ATTENDED

    Sr.

    No.Date

    Company NameResult

    F CAMPUS ATTENDED

    r.o.

    Date Company Name Place Result

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    Student Profile - BiomedicalBatch:

    TRAINING PARTICULARS

    INPLANT TRAINING

    Have you undergone Inplant training? YesNo

    If yes, provide details below

    Sr.No.

    Name of OrganizationPeriod

    From To

    TRAINING PROGRAMS ATTENDED

    Sr.No.

    Date

    Name of the Program PlaceFrom To

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    Student Profile - BiomedicalBatch:

    ACADEMIC PROJECT

    Mini Project Title :

    UG Project Title :

    Software Package :Hardware Package :

    Diploma Project Title :

    Software Package :Hardware Package :

    CONFERENCE / SYMPOSIUM / WORKSHOP / SEMINAR ATTENDED

    Sr.No.

    Date andYear

    Nature of

    theProgram Title of the paper National /International OrganizedBy No. ofDays

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    Student Profile - BiomedicalBatch:

    Plans for the future :

    Interests, Hobbies or anything else :

    Platforms (OS) :Programming Languages :

    Software package :

    Assembly Language :

    College Alumni Details :

    Student Signature -------------------- HOD Signature with Seal

    FAMILY DETAILS:

    Name Relation Age Qualification Occupation

    ADDITIONAL QUALIFICATIONS & INFORMATIONS, IF ANY: