Dibrugarh University

Application Form For Seeking Inspection of Answer Script under the 'Right to information Act, 2005'

(*) Indicates Mandatory Fields.

To
Public Information Officer(Examination)
Dibrugarh University, Dibrugarh

RTI Information::

Whether the above paper was/were applied for re-scrutiny/re-evaluation:

Name(in Capital Letters):

Father's/Husband's/Guardian's Name:

Address

Village/Town:

Post Office:

Police Station:

District:

State:

PIN Code:

Mobile No

Email:

Examination Info

Name of the college:

Examination Name:

Semester/Year:

Roll No:

Program & Semester:

Paper:

Registration No:

Date of declaration of Result:

Admit Card:

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Grade Card:

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Signature:

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Declaration: