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PHARMACY COUNCIL OF INDIA
STAFF DECLARATION FORM
From
Teachers Name KB DURGADEVL (as on University Degree certificate)
Recent Passport size photo of the Employee Signed by DeanPrincipal of the College
Date of Birth amp Age 06091991 amp 26
Qualification
BPhaml
College amp University
KMCollege of Pharmacy
amp DrMGR Medical
University
Year
2013
Registration No with State Pharmacy
Name of the State Pharmacy Council
MPharm
Madurai Medical College
amp DrMGR Medical
University
2016
19474 Al Tamil Nadu State Pharmacy Council
(PhD)others I i
Copies of Registration Certificate and University degreePGPhD be attached
Present Designation ~~~~~~~--_________________
Department ~=-==~-=~=L--_________________
College Dhanalakshmi Srinivasan College of Pharmacy
City~~~~~_______~ _____________________________________
Nature of appointment PermanentlTemporarylAdhocHonoraryPart time
Whether belongs to OGlSCSTOBClEx-serviceOthers
Contd on page 2
2
~~~-
Permanent Residential Address of employee 16Agraharam A vaniya Puram
Madura i-625 012
Copy of PassportlVoter CardfRation CardPAN NolElectricity BilllDriving License Attached as a proof of residence
STD Code Phone No
Phone amp Fax Number Office--~~~~---~~~~~~~~~~~-
with Code Residence 8489447172
~~~-~~~~~~~~~~~~--~~-
E-mail addressdurgaamaigmailcom
Date of joining presen t insti tuti on --O-l~O=-8=-=2-=-O~I--7~~__~___as Assistant Professor (Designation)
Details of the previous appointmentsteaching experience
Position Name of Institution From To Total Experience in years
Lecturer
Reader Assistant Professor
Professor
Principal
1) Before joining present institution I was working at ________~_-------__ as and relieved on ________ after resigningretiring (relieving order is enclosed from the previous institution)
2) I hereby undertake that I have not given my name as teaching faculty in any other Pharmacy institution for teaching any Pharmacy course and not working in any where other than this institution Pharmacy CollegeMedical CollegeDental CollegeIndustryCommunity PharmacyHospital PharmacyGovt Serviceany other service in the State or outside the State in any capacity full-timepart-time other than the above
Contd on page 3
--------------------------
3
3) I have drawn total emoluments from this college as under (Please fill the data oflast academic session) shy
___
TDSAmount Received
April20 May 20
----~----
June 20 July 20 August 20
September 20 October 20 _
November 20 December 20 January 20 February 20 March20
(Copy of my form 16 (TDS certificate) for the last financial year is attached)
PAN ____________ Circle
Declaration
1 I have not worked at any other pharmacy collegeinstitution or presented myself at any inspection during my employment in this college
2 It is declared that each statement andor contents of thisdeclaration made by the undersigned are absolutely true and correct In the event of any statement made in this declaration subsequently turning out to be incorrect or false the undersigned has understood and accepted that such misdeclaration in respect to any content of this declaration shall also be treated as a gross misconduct thereby rendering the undersigned liable for necessary disciplinary action (including removal of his name from Register of Registered Pharmacists)
Signature of the Employee
Date Place
Endorsement
This endorsement is the certification that the undersigned has satisfied himselfherself about the correctness and veracity of each content of this declaration and endorses the abovementioned declaration as true and correct In the event of this declaration turning out to be either incorrect or any part middotof this declaration subsequently turning out to be incorrect or false it is understood and accepted that the undersigned shall also be equally responsible besides the declarant himselfherself for any such misdeclaration or misstatement
Coun ircctorDcanl Jrirlcipal in respect of Teaching Staff
Date Place
27072017
DHANALAKAHMI SRINIVASAN COLLEGE OF PHARMACY Thuraiyur Road Perambalur - 621 212
APPOINTMENT ORDER
To
KB Durgadevi
16Agraharam
Avaniya Puram
tv(adurai -6 J 5 (] 12
W-ith references to your resume and based on the interview conducted bv the - ~
selection committee of Dhanalakshmi Srinivasan Charitable and Educational Trust
you are selected as a Assistant Profess-or in our Proposed Dhanalakshmi
Srinivasan College of PharmacyPerambaluJ
Kindly send your willingness to accept the appointment along with 2
photographs and photocopies along with your Original certificates Relieving order
and Experience certificate
You should obey all the rules and regulations of our College of Pharmacy as
per the discussion
JOINING LETTER
From
KB Durgadevi
16Agraharam
Avaniya Puram
Madurai-625 012
To
The Principal
Dhanalakshmi Srinivasan College of Pharmacy
Perambalur - 621212
Respected Sir
Subject KB Durgadevi Joining as Assistant Professor on 01082017 - reg
With reference to the appointment order I am Joining duty as your institution as
Assistant Professor in the Dhanalakshmi Srinivasan College of Pharmacy in the FN of
01082017 Herewith I am submitting my original certificates ID proof and two photographs as
per your instruction for verification r will abide by the rules and regulations of the trust and
College
Thanking YOLl
Place Perambalur
Date
tt ~
shy
rampi 11 e Ir ~
N
cent z u ~
8 r
Ie ~ ~
~
z u o
-------
It NADU PHARMACY CO Cll CHENNAI
PHARMACiST REGISTRATION CERTIFICATE
CERTIFICATE NO 19474 Al DATED 11th March 2014
THIS S TO CERTIFY THAT KB DURGADEVI BPharm
(fMW daughter of KS Baskaran whose date of birth is
6th September 1991 (Nineteenti(inepoundl[ Ol1~ ) has been duly registered as a
REGISTERED PHtARMACIST and is entitled to aI the privileges granted under The Pharmacy Act 1948 (Central Act No VIII of 1948)
as amended to regulate the practice of Pharmacy In the State of Tamil Nadu
IN WITNESS whereof are herewith affixed the seal of the Tamil Nadu Pharmacy Council and
--- f~ gt ~J)i$P1
IIGC1l bull ~~t v ~ -
~~I)~ lI
Note (1) This certificate shall remain in force (2) The above Photograph is due for change on ~
the Signature of the Registrar of the said Pharmacy Council
ft$~~ _~~OI- w ~
J
K13~uUl~o ~~L Signature of t~e Candidate
1110312019 grace upto
lt
f
FORM -I [See Rule 79 (2)]
Registration of Additional Qualification (Under Section 35 of the Pharmacy Act1948)
(Yfw a-rilliU(JIl(li dilioIUlf 1 6lYliffieat(J d~Jff(]e
ajllteatlllf h(doU) W~middot hef11J ifW(JUed ill llt(l
CfiJieffi9telf 01 (7JiAaUfMwiAl4 flIt tll C(5flil (ftadll JtoJe
arailUlt th~ nflneol th~ illowil1fj cleflirjlet(uj C(PhJUluwi4t
Name KB DURGADEVI
Registrttion Number amp Date
DiplOlnalCeltificateDegree ai1eady registered
DiplomaCertifica teDegree MPbarm now registered (PHARft1ACEl1TlCAL CHEMISTRY)
Date of Addl Qualification Regd 30032017
$lgnature6f tl)e Candidate middotMA~middot ~Ygt- -~ bull_~_bull -~-A-~~ _clt bullbullbull - bullbull) __ - ~
u
cu rdrr t CERTIFICATE S No SEC 43518 31 i91118iji) il6IDIDGU6lnmli1ifeoo 000
OEARiMENT OFGOVERNlvleNTEx~MINATla~J5 cliENNAI-600 oQGmiddotmiddot
middotmiddotWmiddotmiddot6ampJL q Ultirff~~~~middot fh
rfl-gtmiddot~60U u6iramprfl~~I~middotmiddotmiddotmiddot6tJ( gt _ -~Jl lt ~ ~ ~ ~~~ ~
$E$QNOARY SCHOO MING CERTlft(jATE~
LUL 6)l~ffiJ~UW(11~D~ lt) tTunT (JF THE GOVERNMENfOFTA~lIiNAOU-~-
bullj - ~ shy ~ bull
DURGADEVI
t B QI)WLjU QLHrsectJ~j CpiirQeuroU(Yitpoundl
Ltl~lqGluoomG1ieurontl GJuri)IDlciTrorr rT GnJil1l111 lHfEil5TfDeuroll)8ioaHJ (blqgt) WJ
i~riffied that tire above mentioned candldatl3 appeared for tfle SSLC PubilcExamfnatfon and h rained theaf marks
tpound~tblildlru til ( ENGLISH
83 EIGHT THREE
81
88
67
88 EIGHT EIGHT
407 FOUR ZERO
~~ L~lflJ$bfb JDfrlgt1r I DATE OF I3IHTH Li tl~igtlflfaIH I HEGISrEH NO LClttlJJ (aIDlu11_~Lm(IJr~n t TMR CODE NO ADATE
180653 A166000 3105200706091991
I NAME OF THE SCHOOL
SOLJRASHTRA G HSS MADURAl
hID~L~raquoil)U UG1t~ ~IDI[i) filJfjuLu GlurriJ$f 1l)lilimlJdl tl)lillgm (lulU 9GiJGlQJfTjUI1LJgtJJ5IJW lOOurj~ ~l)lUl ~JQril (ljluufi~~tfCJUljlUGlU8i~ (JuglJ$5~ GiiiUtifflID (ID~ ueji) (YlraquoLluJi) tlflSqWlJ Iff(tpji)ib OJ5ITltJii G1ulJJraquoiJf5U)W QUI1(sectbiiiw APass ifll11ft sslc Examination requires a minimum of TlIIrty Five pefont of marks In oach subject Tlris InclUdes passing undef tbe Compartmental System
To ~iJBrrti6lll tlt6 Ul Durgadevi K B
010 Baskaran ltgt o 16 AGRAHARAM ~ AVANIYAPURAM Avaniapuram
ltgt Avanivpuram Madura South Madurai
1 Tamil Naclu 625012 S9344107392
E1IIIIIIIIIIIIIIIllnllllUIIlIIIIU 11111 ~ ML013938343FT
~rfu8)6lT ~$DlTIj 6T6lfirr I YourAadhaar No
9101 6291 4444 ~lJrrg - lfrr$blT~mT w6nft$b6nft6ir ~h1ampITI]Lb
------------------------ ---- --- ------ ------x-~~~~ ~~~_ral~j ~1j8irraDiDl taUl Durgadevi K B
iblm)ll urrwalJriT Father Baskaran UliDbi lblT6ir I DOB Q6091991
Qu61i1JUITOO I Female
9101 6291 4444
2
~~~-
Permanent Residential Address of employee 16Agraharam A vaniya Puram
Madura i-625 012
Copy of PassportlVoter CardfRation CardPAN NolElectricity BilllDriving License Attached as a proof of residence
STD Code Phone No
Phone amp Fax Number Office--~~~~---~~~~~~~~~~~-
with Code Residence 8489447172
~~~-~~~~~~~~~~~~--~~-
E-mail addressdurgaamaigmailcom
Date of joining presen t insti tuti on --O-l~O=-8=-=2-=-O~I--7~~__~___as Assistant Professor (Designation)
Details of the previous appointmentsteaching experience
Position Name of Institution From To Total Experience in years
Lecturer
Reader Assistant Professor
Professor
Principal
1) Before joining present institution I was working at ________~_-------__ as and relieved on ________ after resigningretiring (relieving order is enclosed from the previous institution)
2) I hereby undertake that I have not given my name as teaching faculty in any other Pharmacy institution for teaching any Pharmacy course and not working in any where other than this institution Pharmacy CollegeMedical CollegeDental CollegeIndustryCommunity PharmacyHospital PharmacyGovt Serviceany other service in the State or outside the State in any capacity full-timepart-time other than the above
Contd on page 3
--------------------------
3
3) I have drawn total emoluments from this college as under (Please fill the data oflast academic session) shy
___
TDSAmount Received
April20 May 20
----~----
June 20 July 20 August 20
September 20 October 20 _
November 20 December 20 January 20 February 20 March20
(Copy of my form 16 (TDS certificate) for the last financial year is attached)
PAN ____________ Circle
Declaration
1 I have not worked at any other pharmacy collegeinstitution or presented myself at any inspection during my employment in this college
2 It is declared that each statement andor contents of thisdeclaration made by the undersigned are absolutely true and correct In the event of any statement made in this declaration subsequently turning out to be incorrect or false the undersigned has understood and accepted that such misdeclaration in respect to any content of this declaration shall also be treated as a gross misconduct thereby rendering the undersigned liable for necessary disciplinary action (including removal of his name from Register of Registered Pharmacists)
Signature of the Employee
Date Place
Endorsement
This endorsement is the certification that the undersigned has satisfied himselfherself about the correctness and veracity of each content of this declaration and endorses the abovementioned declaration as true and correct In the event of this declaration turning out to be either incorrect or any part middotof this declaration subsequently turning out to be incorrect or false it is understood and accepted that the undersigned shall also be equally responsible besides the declarant himselfherself for any such misdeclaration or misstatement
Coun ircctorDcanl Jrirlcipal in respect of Teaching Staff
Date Place
27072017
DHANALAKAHMI SRINIVASAN COLLEGE OF PHARMACY Thuraiyur Road Perambalur - 621 212
APPOINTMENT ORDER
To
KB Durgadevi
16Agraharam
Avaniya Puram
tv(adurai -6 J 5 (] 12
W-ith references to your resume and based on the interview conducted bv the - ~
selection committee of Dhanalakshmi Srinivasan Charitable and Educational Trust
you are selected as a Assistant Profess-or in our Proposed Dhanalakshmi
Srinivasan College of PharmacyPerambaluJ
Kindly send your willingness to accept the appointment along with 2
photographs and photocopies along with your Original certificates Relieving order
and Experience certificate
You should obey all the rules and regulations of our College of Pharmacy as
per the discussion
JOINING LETTER
From
KB Durgadevi
16Agraharam
Avaniya Puram
Madurai-625 012
To
The Principal
Dhanalakshmi Srinivasan College of Pharmacy
Perambalur - 621212
Respected Sir
Subject KB Durgadevi Joining as Assistant Professor on 01082017 - reg
With reference to the appointment order I am Joining duty as your institution as
Assistant Professor in the Dhanalakshmi Srinivasan College of Pharmacy in the FN of
01082017 Herewith I am submitting my original certificates ID proof and two photographs as
per your instruction for verification r will abide by the rules and regulations of the trust and
College
Thanking YOLl
Place Perambalur
Date
tt ~
shy
rampi 11 e Ir ~
N
cent z u ~
8 r
Ie ~ ~
~
z u o
-------
It NADU PHARMACY CO Cll CHENNAI
PHARMACiST REGISTRATION CERTIFICATE
CERTIFICATE NO 19474 Al DATED 11th March 2014
THIS S TO CERTIFY THAT KB DURGADEVI BPharm
(fMW daughter of KS Baskaran whose date of birth is
6th September 1991 (Nineteenti(inepoundl[ Ol1~ ) has been duly registered as a
REGISTERED PHtARMACIST and is entitled to aI the privileges granted under The Pharmacy Act 1948 (Central Act No VIII of 1948)
as amended to regulate the practice of Pharmacy In the State of Tamil Nadu
IN WITNESS whereof are herewith affixed the seal of the Tamil Nadu Pharmacy Council and
--- f~ gt ~J)i$P1
IIGC1l bull ~~t v ~ -
~~I)~ lI
Note (1) This certificate shall remain in force (2) The above Photograph is due for change on ~
the Signature of the Registrar of the said Pharmacy Council
ft$~~ _~~OI- w ~
J
K13~uUl~o ~~L Signature of t~e Candidate
1110312019 grace upto
lt
f
FORM -I [See Rule 79 (2)]
Registration of Additional Qualification (Under Section 35 of the Pharmacy Act1948)
(Yfw a-rilliU(JIl(li dilioIUlf 1 6lYliffieat(J d~Jff(]e
ajllteatlllf h(doU) W~middot hef11J ifW(JUed ill llt(l
CfiJieffi9telf 01 (7JiAaUfMwiAl4 flIt tll C(5flil (ftadll JtoJe
arailUlt th~ nflneol th~ illowil1fj cleflirjlet(uj C(PhJUluwi4t
Name KB DURGADEVI
Registrttion Number amp Date
DiplOlnalCeltificateDegree ai1eady registered
DiplomaCertifica teDegree MPbarm now registered (PHARft1ACEl1TlCAL CHEMISTRY)
Date of Addl Qualification Regd 30032017
$lgnature6f tl)e Candidate middotMA~middot ~Ygt- -~ bull_~_bull -~-A-~~ _clt bullbullbull - bullbull) __ - ~
u
cu rdrr t CERTIFICATE S No SEC 43518 31 i91118iji) il6IDIDGU6lnmli1ifeoo 000
OEARiMENT OFGOVERNlvleNTEx~MINATla~J5 cliENNAI-600 oQGmiddotmiddot
middotmiddotWmiddotmiddot6ampJL q Ultirff~~~~middot fh
rfl-gtmiddot~60U u6iramprfl~~I~middotmiddotmiddotmiddot6tJ( gt _ -~Jl lt ~ ~ ~ ~~~ ~
$E$QNOARY SCHOO MING CERTlft(jATE~
LUL 6)l~ffiJ~UW(11~D~ lt) tTunT (JF THE GOVERNMENfOFTA~lIiNAOU-~-
bullj - ~ shy ~ bull
DURGADEVI
t B QI)WLjU QLHrsectJ~j CpiirQeuroU(Yitpoundl
Ltl~lqGluoomG1ieurontl GJuri)IDlciTrorr rT GnJil1l111 lHfEil5TfDeuroll)8ioaHJ (blqgt) WJ
i~riffied that tire above mentioned candldatl3 appeared for tfle SSLC PubilcExamfnatfon and h rained theaf marks
tpound~tblildlru til ( ENGLISH
83 EIGHT THREE
81
88
67
88 EIGHT EIGHT
407 FOUR ZERO
~~ L~lflJ$bfb JDfrlgt1r I DATE OF I3IHTH Li tl~igtlflfaIH I HEGISrEH NO LClttlJJ (aIDlu11_~Lm(IJr~n t TMR CODE NO ADATE
180653 A166000 3105200706091991
I NAME OF THE SCHOOL
SOLJRASHTRA G HSS MADURAl
hID~L~raquoil)U UG1t~ ~IDI[i) filJfjuLu GlurriJ$f 1l)lilimlJdl tl)lillgm (lulU 9GiJGlQJfTjUI1LJgtJJ5IJW lOOurj~ ~l)lUl ~JQril (ljluufi~~tfCJUljlUGlU8i~ (JuglJ$5~ GiiiUtifflID (ID~ ueji) (YlraquoLluJi) tlflSqWlJ Iff(tpji)ib OJ5ITltJii G1ulJJraquoiJf5U)W QUI1(sectbiiiw APass ifll11ft sslc Examination requires a minimum of TlIIrty Five pefont of marks In oach subject Tlris InclUdes passing undef tbe Compartmental System
To ~iJBrrti6lll tlt6 Ul Durgadevi K B
010 Baskaran ltgt o 16 AGRAHARAM ~ AVANIYAPURAM Avaniapuram
ltgt Avanivpuram Madura South Madurai
1 Tamil Naclu 625012 S9344107392
E1IIIIIIIIIIIIIIIllnllllUIIlIIIIU 11111 ~ ML013938343FT
~rfu8)6lT ~$DlTIj 6T6lfirr I YourAadhaar No
9101 6291 4444 ~lJrrg - lfrr$blT~mT w6nft$b6nft6ir ~h1ampITI]Lb
------------------------ ---- --- ------ ------x-~~~~ ~~~_ral~j ~1j8irraDiDl taUl Durgadevi K B
iblm)ll urrwalJriT Father Baskaran UliDbi lblT6ir I DOB Q6091991
Qu61i1JUITOO I Female
9101 6291 4444
--------------------------
3
3) I have drawn total emoluments from this college as under (Please fill the data oflast academic session) shy
___
TDSAmount Received
April20 May 20
----~----
June 20 July 20 August 20
September 20 October 20 _
November 20 December 20 January 20 February 20 March20
(Copy of my form 16 (TDS certificate) for the last financial year is attached)
PAN ____________ Circle
Declaration
1 I have not worked at any other pharmacy collegeinstitution or presented myself at any inspection during my employment in this college
2 It is declared that each statement andor contents of thisdeclaration made by the undersigned are absolutely true and correct In the event of any statement made in this declaration subsequently turning out to be incorrect or false the undersigned has understood and accepted that such misdeclaration in respect to any content of this declaration shall also be treated as a gross misconduct thereby rendering the undersigned liable for necessary disciplinary action (including removal of his name from Register of Registered Pharmacists)
Signature of the Employee
Date Place
Endorsement
This endorsement is the certification that the undersigned has satisfied himselfherself about the correctness and veracity of each content of this declaration and endorses the abovementioned declaration as true and correct In the event of this declaration turning out to be either incorrect or any part middotof this declaration subsequently turning out to be incorrect or false it is understood and accepted that the undersigned shall also be equally responsible besides the declarant himselfherself for any such misdeclaration or misstatement
Coun ircctorDcanl Jrirlcipal in respect of Teaching Staff
Date Place
27072017
DHANALAKAHMI SRINIVASAN COLLEGE OF PHARMACY Thuraiyur Road Perambalur - 621 212
APPOINTMENT ORDER
To
KB Durgadevi
16Agraharam
Avaniya Puram
tv(adurai -6 J 5 (] 12
W-ith references to your resume and based on the interview conducted bv the - ~
selection committee of Dhanalakshmi Srinivasan Charitable and Educational Trust
you are selected as a Assistant Profess-or in our Proposed Dhanalakshmi
Srinivasan College of PharmacyPerambaluJ
Kindly send your willingness to accept the appointment along with 2
photographs and photocopies along with your Original certificates Relieving order
and Experience certificate
You should obey all the rules and regulations of our College of Pharmacy as
per the discussion
JOINING LETTER
From
KB Durgadevi
16Agraharam
Avaniya Puram
Madurai-625 012
To
The Principal
Dhanalakshmi Srinivasan College of Pharmacy
Perambalur - 621212
Respected Sir
Subject KB Durgadevi Joining as Assistant Professor on 01082017 - reg
With reference to the appointment order I am Joining duty as your institution as
Assistant Professor in the Dhanalakshmi Srinivasan College of Pharmacy in the FN of
01082017 Herewith I am submitting my original certificates ID proof and two photographs as
per your instruction for verification r will abide by the rules and regulations of the trust and
College
Thanking YOLl
Place Perambalur
Date
tt ~
shy
rampi 11 e Ir ~
N
cent z u ~
8 r
Ie ~ ~
~
z u o
-------
It NADU PHARMACY CO Cll CHENNAI
PHARMACiST REGISTRATION CERTIFICATE
CERTIFICATE NO 19474 Al DATED 11th March 2014
THIS S TO CERTIFY THAT KB DURGADEVI BPharm
(fMW daughter of KS Baskaran whose date of birth is
6th September 1991 (Nineteenti(inepoundl[ Ol1~ ) has been duly registered as a
REGISTERED PHtARMACIST and is entitled to aI the privileges granted under The Pharmacy Act 1948 (Central Act No VIII of 1948)
as amended to regulate the practice of Pharmacy In the State of Tamil Nadu
IN WITNESS whereof are herewith affixed the seal of the Tamil Nadu Pharmacy Council and
--- f~ gt ~J)i$P1
IIGC1l bull ~~t v ~ -
~~I)~ lI
Note (1) This certificate shall remain in force (2) The above Photograph is due for change on ~
the Signature of the Registrar of the said Pharmacy Council
ft$~~ _~~OI- w ~
J
K13~uUl~o ~~L Signature of t~e Candidate
1110312019 grace upto
lt
f
FORM -I [See Rule 79 (2)]
Registration of Additional Qualification (Under Section 35 of the Pharmacy Act1948)
(Yfw a-rilliU(JIl(li dilioIUlf 1 6lYliffieat(J d~Jff(]e
ajllteatlllf h(doU) W~middot hef11J ifW(JUed ill llt(l
CfiJieffi9telf 01 (7JiAaUfMwiAl4 flIt tll C(5flil (ftadll JtoJe
arailUlt th~ nflneol th~ illowil1fj cleflirjlet(uj C(PhJUluwi4t
Name KB DURGADEVI
Registrttion Number amp Date
DiplOlnalCeltificateDegree ai1eady registered
DiplomaCertifica teDegree MPbarm now registered (PHARft1ACEl1TlCAL CHEMISTRY)
Date of Addl Qualification Regd 30032017
$lgnature6f tl)e Candidate middotMA~middot ~Ygt- -~ bull_~_bull -~-A-~~ _clt bullbullbull - bullbull) __ - ~
u
cu rdrr t CERTIFICATE S No SEC 43518 31 i91118iji) il6IDIDGU6lnmli1ifeoo 000
OEARiMENT OFGOVERNlvleNTEx~MINATla~J5 cliENNAI-600 oQGmiddotmiddot
middotmiddotWmiddotmiddot6ampJL q Ultirff~~~~middot fh
rfl-gtmiddot~60U u6iramprfl~~I~middotmiddotmiddotmiddot6tJ( gt _ -~Jl lt ~ ~ ~ ~~~ ~
$E$QNOARY SCHOO MING CERTlft(jATE~
LUL 6)l~ffiJ~UW(11~D~ lt) tTunT (JF THE GOVERNMENfOFTA~lIiNAOU-~-
bullj - ~ shy ~ bull
DURGADEVI
t B QI)WLjU QLHrsectJ~j CpiirQeuroU(Yitpoundl
Ltl~lqGluoomG1ieurontl GJuri)IDlciTrorr rT GnJil1l111 lHfEil5TfDeuroll)8ioaHJ (blqgt) WJ
i~riffied that tire above mentioned candldatl3 appeared for tfle SSLC PubilcExamfnatfon and h rained theaf marks
tpound~tblildlru til ( ENGLISH
83 EIGHT THREE
81
88
67
88 EIGHT EIGHT
407 FOUR ZERO
~~ L~lflJ$bfb JDfrlgt1r I DATE OF I3IHTH Li tl~igtlflfaIH I HEGISrEH NO LClttlJJ (aIDlu11_~Lm(IJr~n t TMR CODE NO ADATE
180653 A166000 3105200706091991
I NAME OF THE SCHOOL
SOLJRASHTRA G HSS MADURAl
hID~L~raquoil)U UG1t~ ~IDI[i) filJfjuLu GlurriJ$f 1l)lilimlJdl tl)lillgm (lulU 9GiJGlQJfTjUI1LJgtJJ5IJW lOOurj~ ~l)lUl ~JQril (ljluufi~~tfCJUljlUGlU8i~ (JuglJ$5~ GiiiUtifflID (ID~ ueji) (YlraquoLluJi) tlflSqWlJ Iff(tpji)ib OJ5ITltJii G1ulJJraquoiJf5U)W QUI1(sectbiiiw APass ifll11ft sslc Examination requires a minimum of TlIIrty Five pefont of marks In oach subject Tlris InclUdes passing undef tbe Compartmental System
To ~iJBrrti6lll tlt6 Ul Durgadevi K B
010 Baskaran ltgt o 16 AGRAHARAM ~ AVANIYAPURAM Avaniapuram
ltgt Avanivpuram Madura South Madurai
1 Tamil Naclu 625012 S9344107392
E1IIIIIIIIIIIIIIIllnllllUIIlIIIIU 11111 ~ ML013938343FT
~rfu8)6lT ~$DlTIj 6T6lfirr I YourAadhaar No
9101 6291 4444 ~lJrrg - lfrr$blT~mT w6nft$b6nft6ir ~h1ampITI]Lb
------------------------ ---- --- ------ ------x-~~~~ ~~~_ral~j ~1j8irraDiDl taUl Durgadevi K B
iblm)ll urrwalJriT Father Baskaran UliDbi lblT6ir I DOB Q6091991
Qu61i1JUITOO I Female
9101 6291 4444
27072017
DHANALAKAHMI SRINIVASAN COLLEGE OF PHARMACY Thuraiyur Road Perambalur - 621 212
APPOINTMENT ORDER
To
KB Durgadevi
16Agraharam
Avaniya Puram
tv(adurai -6 J 5 (] 12
W-ith references to your resume and based on the interview conducted bv the - ~
selection committee of Dhanalakshmi Srinivasan Charitable and Educational Trust
you are selected as a Assistant Profess-or in our Proposed Dhanalakshmi
Srinivasan College of PharmacyPerambaluJ
Kindly send your willingness to accept the appointment along with 2
photographs and photocopies along with your Original certificates Relieving order
and Experience certificate
You should obey all the rules and regulations of our College of Pharmacy as
per the discussion
JOINING LETTER
From
KB Durgadevi
16Agraharam
Avaniya Puram
Madurai-625 012
To
The Principal
Dhanalakshmi Srinivasan College of Pharmacy
Perambalur - 621212
Respected Sir
Subject KB Durgadevi Joining as Assistant Professor on 01082017 - reg
With reference to the appointment order I am Joining duty as your institution as
Assistant Professor in the Dhanalakshmi Srinivasan College of Pharmacy in the FN of
01082017 Herewith I am submitting my original certificates ID proof and two photographs as
per your instruction for verification r will abide by the rules and regulations of the trust and
College
Thanking YOLl
Place Perambalur
Date
tt ~
shy
rampi 11 e Ir ~
N
cent z u ~
8 r
Ie ~ ~
~
z u o
-------
It NADU PHARMACY CO Cll CHENNAI
PHARMACiST REGISTRATION CERTIFICATE
CERTIFICATE NO 19474 Al DATED 11th March 2014
THIS S TO CERTIFY THAT KB DURGADEVI BPharm
(fMW daughter of KS Baskaran whose date of birth is
6th September 1991 (Nineteenti(inepoundl[ Ol1~ ) has been duly registered as a
REGISTERED PHtARMACIST and is entitled to aI the privileges granted under The Pharmacy Act 1948 (Central Act No VIII of 1948)
as amended to regulate the practice of Pharmacy In the State of Tamil Nadu
IN WITNESS whereof are herewith affixed the seal of the Tamil Nadu Pharmacy Council and
--- f~ gt ~J)i$P1
IIGC1l bull ~~t v ~ -
~~I)~ lI
Note (1) This certificate shall remain in force (2) The above Photograph is due for change on ~
the Signature of the Registrar of the said Pharmacy Council
ft$~~ _~~OI- w ~
J
K13~uUl~o ~~L Signature of t~e Candidate
1110312019 grace upto
lt
f
FORM -I [See Rule 79 (2)]
Registration of Additional Qualification (Under Section 35 of the Pharmacy Act1948)
(Yfw a-rilliU(JIl(li dilioIUlf 1 6lYliffieat(J d~Jff(]e
ajllteatlllf h(doU) W~middot hef11J ifW(JUed ill llt(l
CfiJieffi9telf 01 (7JiAaUfMwiAl4 flIt tll C(5flil (ftadll JtoJe
arailUlt th~ nflneol th~ illowil1fj cleflirjlet(uj C(PhJUluwi4t
Name KB DURGADEVI
Registrttion Number amp Date
DiplOlnalCeltificateDegree ai1eady registered
DiplomaCertifica teDegree MPbarm now registered (PHARft1ACEl1TlCAL CHEMISTRY)
Date of Addl Qualification Regd 30032017
$lgnature6f tl)e Candidate middotMA~middot ~Ygt- -~ bull_~_bull -~-A-~~ _clt bullbullbull - bullbull) __ - ~
u
cu rdrr t CERTIFICATE S No SEC 43518 31 i91118iji) il6IDIDGU6lnmli1ifeoo 000
OEARiMENT OFGOVERNlvleNTEx~MINATla~J5 cliENNAI-600 oQGmiddotmiddot
middotmiddotWmiddotmiddot6ampJL q Ultirff~~~~middot fh
rfl-gtmiddot~60U u6iramprfl~~I~middotmiddotmiddotmiddot6tJ( gt _ -~Jl lt ~ ~ ~ ~~~ ~
$E$QNOARY SCHOO MING CERTlft(jATE~
LUL 6)l~ffiJ~UW(11~D~ lt) tTunT (JF THE GOVERNMENfOFTA~lIiNAOU-~-
bullj - ~ shy ~ bull
DURGADEVI
t B QI)WLjU QLHrsectJ~j CpiirQeuroU(Yitpoundl
Ltl~lqGluoomG1ieurontl GJuri)IDlciTrorr rT GnJil1l111 lHfEil5TfDeuroll)8ioaHJ (blqgt) WJ
i~riffied that tire above mentioned candldatl3 appeared for tfle SSLC PubilcExamfnatfon and h rained theaf marks
tpound~tblildlru til ( ENGLISH
83 EIGHT THREE
81
88
67
88 EIGHT EIGHT
407 FOUR ZERO
~~ L~lflJ$bfb JDfrlgt1r I DATE OF I3IHTH Li tl~igtlflfaIH I HEGISrEH NO LClttlJJ (aIDlu11_~Lm(IJr~n t TMR CODE NO ADATE
180653 A166000 3105200706091991
I NAME OF THE SCHOOL
SOLJRASHTRA G HSS MADURAl
hID~L~raquoil)U UG1t~ ~IDI[i) filJfjuLu GlurriJ$f 1l)lilimlJdl tl)lillgm (lulU 9GiJGlQJfTjUI1LJgtJJ5IJW lOOurj~ ~l)lUl ~JQril (ljluufi~~tfCJUljlUGlU8i~ (JuglJ$5~ GiiiUtifflID (ID~ ueji) (YlraquoLluJi) tlflSqWlJ Iff(tpji)ib OJ5ITltJii G1ulJJraquoiJf5U)W QUI1(sectbiiiw APass ifll11ft sslc Examination requires a minimum of TlIIrty Five pefont of marks In oach subject Tlris InclUdes passing undef tbe Compartmental System
To ~iJBrrti6lll tlt6 Ul Durgadevi K B
010 Baskaran ltgt o 16 AGRAHARAM ~ AVANIYAPURAM Avaniapuram
ltgt Avanivpuram Madura South Madurai
1 Tamil Naclu 625012 S9344107392
E1IIIIIIIIIIIIIIIllnllllUIIlIIIIU 11111 ~ ML013938343FT
~rfu8)6lT ~$DlTIj 6T6lfirr I YourAadhaar No
9101 6291 4444 ~lJrrg - lfrr$blT~mT w6nft$b6nft6ir ~h1ampITI]Lb
------------------------ ---- --- ------ ------x-~~~~ ~~~_ral~j ~1j8irraDiDl taUl Durgadevi K B
iblm)ll urrwalJriT Father Baskaran UliDbi lblT6ir I DOB Q6091991
Qu61i1JUITOO I Female
9101 6291 4444
JOINING LETTER
From
KB Durgadevi
16Agraharam
Avaniya Puram
Madurai-625 012
To
The Principal
Dhanalakshmi Srinivasan College of Pharmacy
Perambalur - 621212
Respected Sir
Subject KB Durgadevi Joining as Assistant Professor on 01082017 - reg
With reference to the appointment order I am Joining duty as your institution as
Assistant Professor in the Dhanalakshmi Srinivasan College of Pharmacy in the FN of
01082017 Herewith I am submitting my original certificates ID proof and two photographs as
per your instruction for verification r will abide by the rules and regulations of the trust and
College
Thanking YOLl
Place Perambalur
Date
tt ~
shy
rampi 11 e Ir ~
N
cent z u ~
8 r
Ie ~ ~
~
z u o
-------
It NADU PHARMACY CO Cll CHENNAI
PHARMACiST REGISTRATION CERTIFICATE
CERTIFICATE NO 19474 Al DATED 11th March 2014
THIS S TO CERTIFY THAT KB DURGADEVI BPharm
(fMW daughter of KS Baskaran whose date of birth is
6th September 1991 (Nineteenti(inepoundl[ Ol1~ ) has been duly registered as a
REGISTERED PHtARMACIST and is entitled to aI the privileges granted under The Pharmacy Act 1948 (Central Act No VIII of 1948)
as amended to regulate the practice of Pharmacy In the State of Tamil Nadu
IN WITNESS whereof are herewith affixed the seal of the Tamil Nadu Pharmacy Council and
--- f~ gt ~J)i$P1
IIGC1l bull ~~t v ~ -
~~I)~ lI
Note (1) This certificate shall remain in force (2) The above Photograph is due for change on ~
the Signature of the Registrar of the said Pharmacy Council
ft$~~ _~~OI- w ~
J
K13~uUl~o ~~L Signature of t~e Candidate
1110312019 grace upto
lt
f
FORM -I [See Rule 79 (2)]
Registration of Additional Qualification (Under Section 35 of the Pharmacy Act1948)
(Yfw a-rilliU(JIl(li dilioIUlf 1 6lYliffieat(J d~Jff(]e
ajllteatlllf h(doU) W~middot hef11J ifW(JUed ill llt(l
CfiJieffi9telf 01 (7JiAaUfMwiAl4 flIt tll C(5flil (ftadll JtoJe
arailUlt th~ nflneol th~ illowil1fj cleflirjlet(uj C(PhJUluwi4t
Name KB DURGADEVI
Registrttion Number amp Date
DiplOlnalCeltificateDegree ai1eady registered
DiplomaCertifica teDegree MPbarm now registered (PHARft1ACEl1TlCAL CHEMISTRY)
Date of Addl Qualification Regd 30032017
$lgnature6f tl)e Candidate middotMA~middot ~Ygt- -~ bull_~_bull -~-A-~~ _clt bullbullbull - bullbull) __ - ~
u
cu rdrr t CERTIFICATE S No SEC 43518 31 i91118iji) il6IDIDGU6lnmli1ifeoo 000
OEARiMENT OFGOVERNlvleNTEx~MINATla~J5 cliENNAI-600 oQGmiddotmiddot
middotmiddotWmiddotmiddot6ampJL q Ultirff~~~~middot fh
rfl-gtmiddot~60U u6iramprfl~~I~middotmiddotmiddotmiddot6tJ( gt _ -~Jl lt ~ ~ ~ ~~~ ~
$E$QNOARY SCHOO MING CERTlft(jATE~
LUL 6)l~ffiJ~UW(11~D~ lt) tTunT (JF THE GOVERNMENfOFTA~lIiNAOU-~-
bullj - ~ shy ~ bull
DURGADEVI
t B QI)WLjU QLHrsectJ~j CpiirQeuroU(Yitpoundl
Ltl~lqGluoomG1ieurontl GJuri)IDlciTrorr rT GnJil1l111 lHfEil5TfDeuroll)8ioaHJ (blqgt) WJ
i~riffied that tire above mentioned candldatl3 appeared for tfle SSLC PubilcExamfnatfon and h rained theaf marks
tpound~tblildlru til ( ENGLISH
83 EIGHT THREE
81
88
67
88 EIGHT EIGHT
407 FOUR ZERO
~~ L~lflJ$bfb JDfrlgt1r I DATE OF I3IHTH Li tl~igtlflfaIH I HEGISrEH NO LClttlJJ (aIDlu11_~Lm(IJr~n t TMR CODE NO ADATE
180653 A166000 3105200706091991
I NAME OF THE SCHOOL
SOLJRASHTRA G HSS MADURAl
hID~L~raquoil)U UG1t~ ~IDI[i) filJfjuLu GlurriJ$f 1l)lilimlJdl tl)lillgm (lulU 9GiJGlQJfTjUI1LJgtJJ5IJW lOOurj~ ~l)lUl ~JQril (ljluufi~~tfCJUljlUGlU8i~ (JuglJ$5~ GiiiUtifflID (ID~ ueji) (YlraquoLluJi) tlflSqWlJ Iff(tpji)ib OJ5ITltJii G1ulJJraquoiJf5U)W QUI1(sectbiiiw APass ifll11ft sslc Examination requires a minimum of TlIIrty Five pefont of marks In oach subject Tlris InclUdes passing undef tbe Compartmental System
To ~iJBrrti6lll tlt6 Ul Durgadevi K B
010 Baskaran ltgt o 16 AGRAHARAM ~ AVANIYAPURAM Avaniapuram
ltgt Avanivpuram Madura South Madurai
1 Tamil Naclu 625012 S9344107392
E1IIIIIIIIIIIIIIIllnllllUIIlIIIIU 11111 ~ ML013938343FT
~rfu8)6lT ~$DlTIj 6T6lfirr I YourAadhaar No
9101 6291 4444 ~lJrrg - lfrr$blT~mT w6nft$b6nft6ir ~h1ampITI]Lb
------------------------ ---- --- ------ ------x-~~~~ ~~~_ral~j ~1j8irraDiDl taUl Durgadevi K B
iblm)ll urrwalJriT Father Baskaran UliDbi lblT6ir I DOB Q6091991
Qu61i1JUITOO I Female
9101 6291 4444
tt ~
shy
rampi 11 e Ir ~
N
cent z u ~
8 r
Ie ~ ~
~
z u o
-------
It NADU PHARMACY CO Cll CHENNAI
PHARMACiST REGISTRATION CERTIFICATE
CERTIFICATE NO 19474 Al DATED 11th March 2014
THIS S TO CERTIFY THAT KB DURGADEVI BPharm
(fMW daughter of KS Baskaran whose date of birth is
6th September 1991 (Nineteenti(inepoundl[ Ol1~ ) has been duly registered as a
REGISTERED PHtARMACIST and is entitled to aI the privileges granted under The Pharmacy Act 1948 (Central Act No VIII of 1948)
as amended to regulate the practice of Pharmacy In the State of Tamil Nadu
IN WITNESS whereof are herewith affixed the seal of the Tamil Nadu Pharmacy Council and
--- f~ gt ~J)i$P1
IIGC1l bull ~~t v ~ -
~~I)~ lI
Note (1) This certificate shall remain in force (2) The above Photograph is due for change on ~
the Signature of the Registrar of the said Pharmacy Council
ft$~~ _~~OI- w ~
J
K13~uUl~o ~~L Signature of t~e Candidate
1110312019 grace upto
lt
f
FORM -I [See Rule 79 (2)]
Registration of Additional Qualification (Under Section 35 of the Pharmacy Act1948)
(Yfw a-rilliU(JIl(li dilioIUlf 1 6lYliffieat(J d~Jff(]e
ajllteatlllf h(doU) W~middot hef11J ifW(JUed ill llt(l
CfiJieffi9telf 01 (7JiAaUfMwiAl4 flIt tll C(5flil (ftadll JtoJe
arailUlt th~ nflneol th~ illowil1fj cleflirjlet(uj C(PhJUluwi4t
Name KB DURGADEVI
Registrttion Number amp Date
DiplOlnalCeltificateDegree ai1eady registered
DiplomaCertifica teDegree MPbarm now registered (PHARft1ACEl1TlCAL CHEMISTRY)
Date of Addl Qualification Regd 30032017
$lgnature6f tl)e Candidate middotMA~middot ~Ygt- -~ bull_~_bull -~-A-~~ _clt bullbullbull - bullbull) __ - ~
u
cu rdrr t CERTIFICATE S No SEC 43518 31 i91118iji) il6IDIDGU6lnmli1ifeoo 000
OEARiMENT OFGOVERNlvleNTEx~MINATla~J5 cliENNAI-600 oQGmiddotmiddot
middotmiddotWmiddotmiddot6ampJL q Ultirff~~~~middot fh
rfl-gtmiddot~60U u6iramprfl~~I~middotmiddotmiddotmiddot6tJ( gt _ -~Jl lt ~ ~ ~ ~~~ ~
$E$QNOARY SCHOO MING CERTlft(jATE~
LUL 6)l~ffiJ~UW(11~D~ lt) tTunT (JF THE GOVERNMENfOFTA~lIiNAOU-~-
bullj - ~ shy ~ bull
DURGADEVI
t B QI)WLjU QLHrsectJ~j CpiirQeuroU(Yitpoundl
Ltl~lqGluoomG1ieurontl GJuri)IDlciTrorr rT GnJil1l111 lHfEil5TfDeuroll)8ioaHJ (blqgt) WJ
i~riffied that tire above mentioned candldatl3 appeared for tfle SSLC PubilcExamfnatfon and h rained theaf marks
tpound~tblildlru til ( ENGLISH
83 EIGHT THREE
81
88
67
88 EIGHT EIGHT
407 FOUR ZERO
~~ L~lflJ$bfb JDfrlgt1r I DATE OF I3IHTH Li tl~igtlflfaIH I HEGISrEH NO LClttlJJ (aIDlu11_~Lm(IJr~n t TMR CODE NO ADATE
180653 A166000 3105200706091991
I NAME OF THE SCHOOL
SOLJRASHTRA G HSS MADURAl
hID~L~raquoil)U UG1t~ ~IDI[i) filJfjuLu GlurriJ$f 1l)lilimlJdl tl)lillgm (lulU 9GiJGlQJfTjUI1LJgtJJ5IJW lOOurj~ ~l)lUl ~JQril (ljluufi~~tfCJUljlUGlU8i~ (JuglJ$5~ GiiiUtifflID (ID~ ueji) (YlraquoLluJi) tlflSqWlJ Iff(tpji)ib OJ5ITltJii G1ulJJraquoiJf5U)W QUI1(sectbiiiw APass ifll11ft sslc Examination requires a minimum of TlIIrty Five pefont of marks In oach subject Tlris InclUdes passing undef tbe Compartmental System
To ~iJBrrti6lll tlt6 Ul Durgadevi K B
010 Baskaran ltgt o 16 AGRAHARAM ~ AVANIYAPURAM Avaniapuram
ltgt Avanivpuram Madura South Madurai
1 Tamil Naclu 625012 S9344107392
E1IIIIIIIIIIIIIIIllnllllUIIlIIIIU 11111 ~ ML013938343FT
~rfu8)6lT ~$DlTIj 6T6lfirr I YourAadhaar No
9101 6291 4444 ~lJrrg - lfrr$blT~mT w6nft$b6nft6ir ~h1ampITI]Lb
------------------------ ---- --- ------ ------x-~~~~ ~~~_ral~j ~1j8irraDiDl taUl Durgadevi K B
iblm)ll urrwalJriT Father Baskaran UliDbi lblT6ir I DOB Q6091991
Qu61i1JUITOO I Female
9101 6291 4444
~
z u o
-------
It NADU PHARMACY CO Cll CHENNAI
PHARMACiST REGISTRATION CERTIFICATE
CERTIFICATE NO 19474 Al DATED 11th March 2014
THIS S TO CERTIFY THAT KB DURGADEVI BPharm
(fMW daughter of KS Baskaran whose date of birth is
6th September 1991 (Nineteenti(inepoundl[ Ol1~ ) has been duly registered as a
REGISTERED PHtARMACIST and is entitled to aI the privileges granted under The Pharmacy Act 1948 (Central Act No VIII of 1948)
as amended to regulate the practice of Pharmacy In the State of Tamil Nadu
IN WITNESS whereof are herewith affixed the seal of the Tamil Nadu Pharmacy Council and
--- f~ gt ~J)i$P1
IIGC1l bull ~~t v ~ -
~~I)~ lI
Note (1) This certificate shall remain in force (2) The above Photograph is due for change on ~
the Signature of the Registrar of the said Pharmacy Council
ft$~~ _~~OI- w ~
J
K13~uUl~o ~~L Signature of t~e Candidate
1110312019 grace upto
lt
f
FORM -I [See Rule 79 (2)]
Registration of Additional Qualification (Under Section 35 of the Pharmacy Act1948)
(Yfw a-rilliU(JIl(li dilioIUlf 1 6lYliffieat(J d~Jff(]e
ajllteatlllf h(doU) W~middot hef11J ifW(JUed ill llt(l
CfiJieffi9telf 01 (7JiAaUfMwiAl4 flIt tll C(5flil (ftadll JtoJe
arailUlt th~ nflneol th~ illowil1fj cleflirjlet(uj C(PhJUluwi4t
Name KB DURGADEVI
Registrttion Number amp Date
DiplOlnalCeltificateDegree ai1eady registered
DiplomaCertifica teDegree MPbarm now registered (PHARft1ACEl1TlCAL CHEMISTRY)
Date of Addl Qualification Regd 30032017
$lgnature6f tl)e Candidate middotMA~middot ~Ygt- -~ bull_~_bull -~-A-~~ _clt bullbullbull - bullbull) __ - ~
u
cu rdrr t CERTIFICATE S No SEC 43518 31 i91118iji) il6IDIDGU6lnmli1ifeoo 000
OEARiMENT OFGOVERNlvleNTEx~MINATla~J5 cliENNAI-600 oQGmiddotmiddot
middotmiddotWmiddotmiddot6ampJL q Ultirff~~~~middot fh
rfl-gtmiddot~60U u6iramprfl~~I~middotmiddotmiddotmiddot6tJ( gt _ -~Jl lt ~ ~ ~ ~~~ ~
$E$QNOARY SCHOO MING CERTlft(jATE~
LUL 6)l~ffiJ~UW(11~D~ lt) tTunT (JF THE GOVERNMENfOFTA~lIiNAOU-~-
bullj - ~ shy ~ bull
DURGADEVI
t B QI)WLjU QLHrsectJ~j CpiirQeuroU(Yitpoundl
Ltl~lqGluoomG1ieurontl GJuri)IDlciTrorr rT GnJil1l111 lHfEil5TfDeuroll)8ioaHJ (blqgt) WJ
i~riffied that tire above mentioned candldatl3 appeared for tfle SSLC PubilcExamfnatfon and h rained theaf marks
tpound~tblildlru til ( ENGLISH
83 EIGHT THREE
81
88
67
88 EIGHT EIGHT
407 FOUR ZERO
~~ L~lflJ$bfb JDfrlgt1r I DATE OF I3IHTH Li tl~igtlflfaIH I HEGISrEH NO LClttlJJ (aIDlu11_~Lm(IJr~n t TMR CODE NO ADATE
180653 A166000 3105200706091991
I NAME OF THE SCHOOL
SOLJRASHTRA G HSS MADURAl
hID~L~raquoil)U UG1t~ ~IDI[i) filJfjuLu GlurriJ$f 1l)lilimlJdl tl)lillgm (lulU 9GiJGlQJfTjUI1LJgtJJ5IJW lOOurj~ ~l)lUl ~JQril (ljluufi~~tfCJUljlUGlU8i~ (JuglJ$5~ GiiiUtifflID (ID~ ueji) (YlraquoLluJi) tlflSqWlJ Iff(tpji)ib OJ5ITltJii G1ulJJraquoiJf5U)W QUI1(sectbiiiw APass ifll11ft sslc Examination requires a minimum of TlIIrty Five pefont of marks In oach subject Tlris InclUdes passing undef tbe Compartmental System
To ~iJBrrti6lll tlt6 Ul Durgadevi K B
010 Baskaran ltgt o 16 AGRAHARAM ~ AVANIYAPURAM Avaniapuram
ltgt Avanivpuram Madura South Madurai
1 Tamil Naclu 625012 S9344107392
E1IIIIIIIIIIIIIIIllnllllUIIlIIIIU 11111 ~ ML013938343FT
~rfu8)6lT ~$DlTIj 6T6lfirr I YourAadhaar No
9101 6291 4444 ~lJrrg - lfrr$blT~mT w6nft$b6nft6ir ~h1ampITI]Lb
------------------------ ---- --- ------ ------x-~~~~ ~~~_ral~j ~1j8irraDiDl taUl Durgadevi K B
iblm)ll urrwalJriT Father Baskaran UliDbi lblT6ir I DOB Q6091991
Qu61i1JUITOO I Female
9101 6291 4444
-------
It NADU PHARMACY CO Cll CHENNAI
PHARMACiST REGISTRATION CERTIFICATE
CERTIFICATE NO 19474 Al DATED 11th March 2014
THIS S TO CERTIFY THAT KB DURGADEVI BPharm
(fMW daughter of KS Baskaran whose date of birth is
6th September 1991 (Nineteenti(inepoundl[ Ol1~ ) has been duly registered as a
REGISTERED PHtARMACIST and is entitled to aI the privileges granted under The Pharmacy Act 1948 (Central Act No VIII of 1948)
as amended to regulate the practice of Pharmacy In the State of Tamil Nadu
IN WITNESS whereof are herewith affixed the seal of the Tamil Nadu Pharmacy Council and
--- f~ gt ~J)i$P1
IIGC1l bull ~~t v ~ -
~~I)~ lI
Note (1) This certificate shall remain in force (2) The above Photograph is due for change on ~
the Signature of the Registrar of the said Pharmacy Council
ft$~~ _~~OI- w ~
J
K13~uUl~o ~~L Signature of t~e Candidate
1110312019 grace upto
lt
f
FORM -I [See Rule 79 (2)]
Registration of Additional Qualification (Under Section 35 of the Pharmacy Act1948)
(Yfw a-rilliU(JIl(li dilioIUlf 1 6lYliffieat(J d~Jff(]e
ajllteatlllf h(doU) W~middot hef11J ifW(JUed ill llt(l
CfiJieffi9telf 01 (7JiAaUfMwiAl4 flIt tll C(5flil (ftadll JtoJe
arailUlt th~ nflneol th~ illowil1fj cleflirjlet(uj C(PhJUluwi4t
Name KB DURGADEVI
Registrttion Number amp Date
DiplOlnalCeltificateDegree ai1eady registered
DiplomaCertifica teDegree MPbarm now registered (PHARft1ACEl1TlCAL CHEMISTRY)
Date of Addl Qualification Regd 30032017
$lgnature6f tl)e Candidate middotMA~middot ~Ygt- -~ bull_~_bull -~-A-~~ _clt bullbullbull - bullbull) __ - ~
u
cu rdrr t CERTIFICATE S No SEC 43518 31 i91118iji) il6IDIDGU6lnmli1ifeoo 000
OEARiMENT OFGOVERNlvleNTEx~MINATla~J5 cliENNAI-600 oQGmiddotmiddot
middotmiddotWmiddotmiddot6ampJL q Ultirff~~~~middot fh
rfl-gtmiddot~60U u6iramprfl~~I~middotmiddotmiddotmiddot6tJ( gt _ -~Jl lt ~ ~ ~ ~~~ ~
$E$QNOARY SCHOO MING CERTlft(jATE~
LUL 6)l~ffiJ~UW(11~D~ lt) tTunT (JF THE GOVERNMENfOFTA~lIiNAOU-~-
bullj - ~ shy ~ bull
DURGADEVI
t B QI)WLjU QLHrsectJ~j CpiirQeuroU(Yitpoundl
Ltl~lqGluoomG1ieurontl GJuri)IDlciTrorr rT GnJil1l111 lHfEil5TfDeuroll)8ioaHJ (blqgt) WJ
i~riffied that tire above mentioned candldatl3 appeared for tfle SSLC PubilcExamfnatfon and h rained theaf marks
tpound~tblildlru til ( ENGLISH
83 EIGHT THREE
81
88
67
88 EIGHT EIGHT
407 FOUR ZERO
~~ L~lflJ$bfb JDfrlgt1r I DATE OF I3IHTH Li tl~igtlflfaIH I HEGISrEH NO LClttlJJ (aIDlu11_~Lm(IJr~n t TMR CODE NO ADATE
180653 A166000 3105200706091991
I NAME OF THE SCHOOL
SOLJRASHTRA G HSS MADURAl
hID~L~raquoil)U UG1t~ ~IDI[i) filJfjuLu GlurriJ$f 1l)lilimlJdl tl)lillgm (lulU 9GiJGlQJfTjUI1LJgtJJ5IJW lOOurj~ ~l)lUl ~JQril (ljluufi~~tfCJUljlUGlU8i~ (JuglJ$5~ GiiiUtifflID (ID~ ueji) (YlraquoLluJi) tlflSqWlJ Iff(tpji)ib OJ5ITltJii G1ulJJraquoiJf5U)W QUI1(sectbiiiw APass ifll11ft sslc Examination requires a minimum of TlIIrty Five pefont of marks In oach subject Tlris InclUdes passing undef tbe Compartmental System
To ~iJBrrti6lll tlt6 Ul Durgadevi K B
010 Baskaran ltgt o 16 AGRAHARAM ~ AVANIYAPURAM Avaniapuram
ltgt Avanivpuram Madura South Madurai
1 Tamil Naclu 625012 S9344107392
E1IIIIIIIIIIIIIIIllnllllUIIlIIIIU 11111 ~ ML013938343FT
~rfu8)6lT ~$DlTIj 6T6lfirr I YourAadhaar No
9101 6291 4444 ~lJrrg - lfrr$blT~mT w6nft$b6nft6ir ~h1ampITI]Lb
------------------------ ---- --- ------ ------x-~~~~ ~~~_ral~j ~1j8irraDiDl taUl Durgadevi K B
iblm)ll urrwalJriT Father Baskaran UliDbi lblT6ir I DOB Q6091991
Qu61i1JUITOO I Female
9101 6291 4444
FORM -I [See Rule 79 (2)]
Registration of Additional Qualification (Under Section 35 of the Pharmacy Act1948)
(Yfw a-rilliU(JIl(li dilioIUlf 1 6lYliffieat(J d~Jff(]e
ajllteatlllf h(doU) W~middot hef11J ifW(JUed ill llt(l
CfiJieffi9telf 01 (7JiAaUfMwiAl4 flIt tll C(5flil (ftadll JtoJe
arailUlt th~ nflneol th~ illowil1fj cleflirjlet(uj C(PhJUluwi4t
Name KB DURGADEVI
Registrttion Number amp Date
DiplOlnalCeltificateDegree ai1eady registered
DiplomaCertifica teDegree MPbarm now registered (PHARft1ACEl1TlCAL CHEMISTRY)
Date of Addl Qualification Regd 30032017
$lgnature6f tl)e Candidate middotMA~middot ~Ygt- -~ bull_~_bull -~-A-~~ _clt bullbullbull - bullbull) __ - ~
u
cu rdrr t CERTIFICATE S No SEC 43518 31 i91118iji) il6IDIDGU6lnmli1ifeoo 000
OEARiMENT OFGOVERNlvleNTEx~MINATla~J5 cliENNAI-600 oQGmiddotmiddot
middotmiddotWmiddotmiddot6ampJL q Ultirff~~~~middot fh
rfl-gtmiddot~60U u6iramprfl~~I~middotmiddotmiddotmiddot6tJ( gt _ -~Jl lt ~ ~ ~ ~~~ ~
$E$QNOARY SCHOO MING CERTlft(jATE~
LUL 6)l~ffiJ~UW(11~D~ lt) tTunT (JF THE GOVERNMENfOFTA~lIiNAOU-~-
bullj - ~ shy ~ bull
DURGADEVI
t B QI)WLjU QLHrsectJ~j CpiirQeuroU(Yitpoundl
Ltl~lqGluoomG1ieurontl GJuri)IDlciTrorr rT GnJil1l111 lHfEil5TfDeuroll)8ioaHJ (blqgt) WJ
i~riffied that tire above mentioned candldatl3 appeared for tfle SSLC PubilcExamfnatfon and h rained theaf marks
tpound~tblildlru til ( ENGLISH
83 EIGHT THREE
81
88
67
88 EIGHT EIGHT
407 FOUR ZERO
~~ L~lflJ$bfb JDfrlgt1r I DATE OF I3IHTH Li tl~igtlflfaIH I HEGISrEH NO LClttlJJ (aIDlu11_~Lm(IJr~n t TMR CODE NO ADATE
180653 A166000 3105200706091991
I NAME OF THE SCHOOL
SOLJRASHTRA G HSS MADURAl
hID~L~raquoil)U UG1t~ ~IDI[i) filJfjuLu GlurriJ$f 1l)lilimlJdl tl)lillgm (lulU 9GiJGlQJfTjUI1LJgtJJ5IJW lOOurj~ ~l)lUl ~JQril (ljluufi~~tfCJUljlUGlU8i~ (JuglJ$5~ GiiiUtifflID (ID~ ueji) (YlraquoLluJi) tlflSqWlJ Iff(tpji)ib OJ5ITltJii G1ulJJraquoiJf5U)W QUI1(sectbiiiw APass ifll11ft sslc Examination requires a minimum of TlIIrty Five pefont of marks In oach subject Tlris InclUdes passing undef tbe Compartmental System
To ~iJBrrti6lll tlt6 Ul Durgadevi K B
010 Baskaran ltgt o 16 AGRAHARAM ~ AVANIYAPURAM Avaniapuram
ltgt Avanivpuram Madura South Madurai
1 Tamil Naclu 625012 S9344107392
E1IIIIIIIIIIIIIIIllnllllUIIlIIIIU 11111 ~ ML013938343FT
~rfu8)6lT ~$DlTIj 6T6lfirr I YourAadhaar No
9101 6291 4444 ~lJrrg - lfrr$blT~mT w6nft$b6nft6ir ~h1ampITI]Lb
------------------------ ---- --- ------ ------x-~~~~ ~~~_ral~j ~1j8irraDiDl taUl Durgadevi K B
iblm)ll urrwalJriT Father Baskaran UliDbi lblT6ir I DOB Q6091991
Qu61i1JUITOO I Female
9101 6291 4444
u
cu rdrr t CERTIFICATE S No SEC 43518 31 i91118iji) il6IDIDGU6lnmli1ifeoo 000
OEARiMENT OFGOVERNlvleNTEx~MINATla~J5 cliENNAI-600 oQGmiddotmiddot
middotmiddotWmiddotmiddot6ampJL q Ultirff~~~~middot fh
rfl-gtmiddot~60U u6iramprfl~~I~middotmiddotmiddotmiddot6tJ( gt _ -~Jl lt ~ ~ ~ ~~~ ~
$E$QNOARY SCHOO MING CERTlft(jATE~
LUL 6)l~ffiJ~UW(11~D~ lt) tTunT (JF THE GOVERNMENfOFTA~lIiNAOU-~-
bullj - ~ shy ~ bull
DURGADEVI
t B QI)WLjU QLHrsectJ~j CpiirQeuroU(Yitpoundl
Ltl~lqGluoomG1ieurontl GJuri)IDlciTrorr rT GnJil1l111 lHfEil5TfDeuroll)8ioaHJ (blqgt) WJ
i~riffied that tire above mentioned candldatl3 appeared for tfle SSLC PubilcExamfnatfon and h rained theaf marks
tpound~tblildlru til ( ENGLISH
83 EIGHT THREE
81
88
67
88 EIGHT EIGHT
407 FOUR ZERO
~~ L~lflJ$bfb JDfrlgt1r I DATE OF I3IHTH Li tl~igtlflfaIH I HEGISrEH NO LClttlJJ (aIDlu11_~Lm(IJr~n t TMR CODE NO ADATE
180653 A166000 3105200706091991
I NAME OF THE SCHOOL
SOLJRASHTRA G HSS MADURAl
hID~L~raquoil)U UG1t~ ~IDI[i) filJfjuLu GlurriJ$f 1l)lilimlJdl tl)lillgm (lulU 9GiJGlQJfTjUI1LJgtJJ5IJW lOOurj~ ~l)lUl ~JQril (ljluufi~~tfCJUljlUGlU8i~ (JuglJ$5~ GiiiUtifflID (ID~ ueji) (YlraquoLluJi) tlflSqWlJ Iff(tpji)ib OJ5ITltJii G1ulJJraquoiJf5U)W QUI1(sectbiiiw APass ifll11ft sslc Examination requires a minimum of TlIIrty Five pefont of marks In oach subject Tlris InclUdes passing undef tbe Compartmental System
To ~iJBrrti6lll tlt6 Ul Durgadevi K B
010 Baskaran ltgt o 16 AGRAHARAM ~ AVANIYAPURAM Avaniapuram
ltgt Avanivpuram Madura South Madurai
1 Tamil Naclu 625012 S9344107392
E1IIIIIIIIIIIIIIIllnllllUIIlIIIIU 11111 ~ ML013938343FT
~rfu8)6lT ~$DlTIj 6T6lfirr I YourAadhaar No
9101 6291 4444 ~lJrrg - lfrr$blT~mT w6nft$b6nft6ir ~h1ampITI]Lb
------------------------ ---- --- ------ ------x-~~~~ ~~~_ral~j ~1j8irraDiDl taUl Durgadevi K B
iblm)ll urrwalJriT Father Baskaran UliDbi lblT6ir I DOB Q6091991
Qu61i1JUITOO I Female
9101 6291 4444
To ~iJBrrti6lll tlt6 Ul Durgadevi K B
010 Baskaran ltgt o 16 AGRAHARAM ~ AVANIYAPURAM Avaniapuram
ltgt Avanivpuram Madura South Madurai
1 Tamil Naclu 625012 S9344107392
E1IIIIIIIIIIIIIIIllnllllUIIlIIIIU 11111 ~ ML013938343FT
~rfu8)6lT ~$DlTIj 6T6lfirr I YourAadhaar No
9101 6291 4444 ~lJrrg - lfrr$blT~mT w6nft$b6nft6ir ~h1ampITI]Lb
------------------------ ---- --- ------ ------x-~~~~ ~~~_ral~j ~1j8irraDiDl taUl Durgadevi K B
iblm)ll urrwalJriT Father Baskaran UliDbi lblT6ir I DOB Q6091991
Qu61i1JUITOO I Female
9101 6291 4444