Anti-Ragging Complaint Form Anti-Ragging Complaint FormFull Name of Student (Victim)Year / Batch / SemesterEmail IDFather's / Guardian's NameRoll / Registration NumberGender Male Female OtherCourse- Select Course -A.N.M.G.N.M.B.Sc. NursingCT TechnicianDialysis TechnicianOT TechnicianPhysiotherapyMobile NumberGender (If Other)Category General SC ST OBC OtherCategory (If Other)Residential AddressHostel Resident? Yes NoDate of IncidentTime of IncidentLocation of IncidentDescription of the Incident ( Max 500 Characters)Name of Accused (If Known)Witnesses (If Any)Have You Informed Anyone Else (E.g. Warden, Teacher)? Yes NoIf Yes Whom?Any Evidence Submitted (Photos, Messages, Video, Audio etc.) Yes NoPlease upload the supporting evidence (jpg, png, jpeg, video, audio) Max 10 MBUpload File Declaration I, the undersigned, declare that all the information provided above is true and correct to the best of my knowledge. I request the Anti-Ragging Committee to take appropriate action.Signature of Student (Max Size 100 KB)Upload File DateSubmit Form
