APPLICATION FOR FINAL GRADE CARD

1. Name in full : (As per Last Qualifying degree Certificate)

YASH LADHA

2. Short name : (within 16 letters)

Yash

3. Institute Roll Number : 10GG20038

4. Address :(Where the Grade Card is to be sent)

C/O Ganesh Kumar LadhaM.G Road, Islampur Bazar

IslampurWest BengalIndiaPIN-733202Phone No-9832871741

5. Branch of Study : APPLIED GEOLOGY (M.Sc. 5Y)6. Degree Obtained : 5 YRS M.SC

Date : ---------------------------------------------------- Signature of Applicant

INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR