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O’ZBEKISTON RESPUBLIKASI
OLIY VA O’RTA MAXSUS TA’LIM VAZIRLIGI

JIZZAX POLITEXNIKA INSTITUTI


SHAXSIY HUJJATLAR YIG’MA JILDI №____
Familiyasi____________________________________________________________________________
Ismi____________________________________Sharifi________________________________________
Ta’lim yo’nalishi_______________________________________________________________________
Institutga kirgan yili, buyruq №__________________________________________________________
Texnikumni tugatgan yili_____________________________________________________
Qo’shimcha ma’lumotlar:

  1. Xalqaro va respublika olimpiadalari, tanlovlari va musobaqalari g’olibi_____________________

  2. Harbiy qism tavsiyanomasi________________________________________________________

  3. Nogironligi to’g’risida ma’lumot____________________________________________________

  4. Chin yetimligi to’g’risida ma’lumot_________________________________________________

Texnikum manzili


Viloyat_____________________________________________________________
Tuman (shahar) ______________________________________________________
Diplom bali________ Texnikum telefon raqami________

Yashash manzili


Viloyat _____________________________________________________________
Tuman(shahar)_______________________________________________________
Qishloq_____________________________________________________________
Ko’cha _____________________________________________________________
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Ota-onasini tel. nomeri ________________________________________________
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