Revaluation Form

Name of the Constituent Faculty

Course

Name of Candidate

PRN No.

Seat No.

Examination

Mark Statement No.

Year & Month of the examination

Centre at which appeared for Theory Examination

Result declared on

Result

Subject	Marks Obtained	Marks Out of

Amount as the fees for Revaluation/Reverification(retotaling)

Name of the Bank

D.D. No.

D.D. Date

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