SMU-RC-7F3A9C
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Sylhet Medical University
সিলেট মেডিকেল বিশ্ববিদ্যালয়
Sylhet-3100, Bangladesh
No image
45mm × 55mm
45mm × 55mm
Student Registration Form
(For Affiliated College)
(To be filled out in block letters by the applicant and submitted to the Office of the Registrar after being countersigned by proper authority along with all fees as per rules.)
Name of college / institute:Sylhet Osmani Medical College
Name of the Course:MBBS
Registration No.:
SMU202200187
Session:2022-23
(To be filled by Sylhet Medical University)
01.Name of the applicant:Md Rafiqul Islam
(In legible block letters exactly as it appears in the SSC or Equivalent Examination.)
02.Father's Name:Md Abdul Karim
03.Mother's Name:Rahima Begum
04.Permanent Address:Vill: Kumarpara, P.O: Sylhet Sadar, Dist: Sylhet
05.Present Address:Block A, Kumarpara, Sylhet
06.Nationality:Bangladeshi (by birth)
07.NID / Birth Reg. No. / Passport No.:1990xxxxxx
08.Lawful guardian's name & address in absence of father:N/A
09.Local guardian's name, address, mobile & relationship:Md Abdul Karim, Kumarpara, Sylhet · 01711-223300 · Father
10.Discipline / Subject to be admitted into:MBBS (Bachelor of Medicine & Bachelor of Surgery)
Year:1st
Date of admission:15 Jan 2022
Class roll:187
11.Date of Birth (according to SSC or Equivalent Examination):14 March 2002
12.Father's / Guardian's monthly income:৳ 65,000In words:Sixty-five thousand taka
13.Applicant's personal mobile number (for official communication):01711-223344
14.Applicant's personal Email (for official communication):rafiqul.smu@example.com
15.Applicant's blood group:O+
Academic / Examination history
| Examination | Board / Institution | Year | GPA / Result |
|---|---|---|---|
| SSC | Sylhet Education Board | 2017 | 5.00 |
| HSC | Sylhet Education Board | 2019 | 5.00 |
| 1st Professional MBBS | Sylhet Medical University | 2026 | Passed (205) |
College seal
Signature of the Principal
Signature of the Applicant
Registrar seal
Registrar, SMU
Sylhet Medical University
সিলেট মেডিকেল বিশ্ববিদ্যালয়
Sylhet-3100, Bangladesh
No image
20mm × 25mm
20mm × 25mm
Registration Card
Registration No.:
SMU202200187
Session:2022-23
Name of the Course:MBBS
Name:Md Rafiqul Islam
Father's Name:Md Abdul Karim
Mother's Name:Rahima Begum
Sylhet Osmani Medical College's student has been registered as a student in this university.
SMU-RC-7F3A9C
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Seal
Registrar
Sylhet Medical University
This is a system-generated, QR-verifiable document of Sylhet Medical University.