DATE

NAME

ROLE Student Faculty Non-Teaching

ROLL NUMBER/FACULTY ID/STAFF ID

DEPARTMENT B.Pharmacy M.Pharmacy

YEAR OF STUDY FIRST YEAR SECOND YEAR THIRD YEAR FINAL YEAR

E-MAIL ADDRESS

MOBILE NUMBER

GRIEVANCE TYPE Infrastructure Related Women Grievance / Sexual Harassment Related Ragging Related Faculty Related Hostel Related Examination Related Other

GRIEVANCE

SUBMIT GRIEVANCE

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