Alisher navoiy nomidagi samarqanbd davlat universiteti

SAMARQAND DAVLAT UNIVERSITETI
T ALABANING SHAXSIY VARAQASI №
Fakultet _______________________________

Yo`nalish_____________________

Ta`lim turi__________________________________________________

Familyasi Ismi_ _______ Otasining ismi ________ __

1.Jinsi ____________
2.Tugilgan yili va oyi________________________
3.Tugilgan joyi ____________________________
4.Millati__________________________________
5.Ma’lumoti(qaysi o’quv yurtini qachon va qaerda tugatgan) __________________ ___________________________________
6. Pasport seriyasi__________________________
7. Pasport raqami __________________________
8. Kim tomondan qachon berilgan_____________
________________________________________
9.Oilaviy ahvoli (oilasi va farzandlari haqida ma’lumot ularning yashash joyi )______________
____________________________________________________________________________________

7. Ota-onasi haqida ma`lumot (yoshi, yashash joyi va ish joyi)________________________________

__________________________________________________________________________________________________________________________________________________________________________________________________________________8.Manzili a)_______________________________
^{doimiy yashash joyi}
________________________________________
b)________________________________________
vaqtinchalik yashash joyi


“____”________________________200___yil
___________________shaxsiy imzo

O`QISH JARAYONINI QAYD QILISH