Talabaning shaxsiy varaqasi

RASM

Toshkent irrigatsiya va qishloq xo’jaligini mexanizatiyalash muhandislari institutining Buxoro filiali

(oliy o`quv yurtining nomi)

,,Gidromelioratsiya’’

fakulteti

TALABANING SHAXSIY VARAQASI

kunduzgi bo`lim

1.______________________________________________________________________

( familiyasi, ismi, sharifi)

2. Talabalikka qabul qilinganligi to`g`risida buyruq raqami ____va sanasi ____________

3. To`plagan balli __________ (davlat byudjeti yoki shartnoma)

4. Talabalik guvohnomasi raqami ___________ kursi ________ va guruhi ___________

5. Mutahassisligi__________________________________________________________

_______________________________________________________________________

6. Pasport seriyasi _________ № ________ berilgan sanasi ____________Kim tomonidan berildi _________________________________________________________

________________________________________________________________________

7. Millati ____________________ Jinsi _______________________________________

8. Tug`ilgan sanasi va joyi __________________________________________________

________________________________________________________________________

9. Doimiy yashash manzili __________________________________________________

_____________________________________________tel: _______________________

10. Vaqtincha yashash manzili ______________________________________________

_________________________________________________ tel: ___________________

11. Maktabni tugatgan yili _____________________ maktab raqami № _____________

12. Maktabda o`qigan horijiy til _____________________________________________

13. Harbiy hizmatda bo`lgan yili: boshi va oxiri _________________________________

14. Harbiy qism manzili va raqami ( tavsiyanoma bilan kirganligi va nomeri) _________

________________________________________________________________________

15. Qo`shin turi _______________________ Darajasi ___________________________

16. Oilaviy ahvoli ______________________ Bolalari ___________________________

17. Ta`minlanganlik holati __________________________________________________

18. Otasi ________________________________________________________________

(familiyasi, ismi, sharifi)

19. Otasining ish joyi va telefoni _____________________________________________

________________________________________________________________________

20. Onasi _______________________________________________________________

(familiyasi, ismi, sharifi)

21.Onasining ish joyi va telefoni _____________________________________________

________________________________________________________________________

22. Qo`shimcha ma`lumotlar ________________________________________________

________________________________________________________________________________________________________________________________________________

________________________________ __________________

(familiyasi, ismi, sharifi) (imzo)

____________________________

(to`ldirilgan sana)