(Enrolment ID)B301F84

Zone/Scrutiny

Payment DetailsRs. 1500.00

2GE

(D.O.B)

Qualification Details (Exam City 1)

Chhatbar Hardikkumar Chandrakantbhai(Full Name of the Applicant)

10 Oct 1993 Male

Indian National

GEN No

B.E.

Chandrakant M. Chhatbar

Gujarat 364001

GEC BHAVNAGAR

Communication Address

Graduated: Yes; Year of Graduation: 2015Electronics & Comm./Electronics Engg./Comm.

I hereby declare that all the particulars stated in this application form are true to the best of my knowledge andbelief. I have read the Information Brochure and I shall abide by the terms and conditions therein. Theresponsibility of following the GATE 2016 website and meeting various deadlines lies with me. In the event ofsuppression or distortion of any fact in my application form, I understand that I will be denied the opportunityto appear in GATE 2016. Further, if any suppression or distortion of facts is found after appearing in theexam, any admission/degree/benefit acquired on the basis of GATE 2016 score/marks is liable to becancelled.

DigitalFingerprint:

OnlinePayment Ref. No.: IG0ASMZNC2

P-304, GOKULDHAM SOCIETY,OPP. TOP 3 CINEMATALAJA ROADBhavnagarGujarat 36400190332 16780 (Mobile No.)

hardikchhatbar10@gmail.com

Zonal GATE Office ContactChairperson GATE

Powai, Mumbai 400076

6e7659e1d13b2680e361b06f62af8744

GATE Exam Details

(Exam City 2)

22/09/2015

Bhavnagar

GATE 2016

(Exam City 3)

(Gender) (Category) (PD Status)

GATE Paper Code

9723875736

ECBhavnagar , GJ

Rajkot , GJ

Ahmedabad , GJ

Indian Institute of Technology Bombay

(Parent's Mobile Number) (Name of the Parent)

B301F84

(Electronics and Communication Engineering)