Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
Electro-Technical Officers Course
(Pre-sea Training & Certification for Merchant Ships)


Dossier ID: ETO2167527
Full Name (as per Passport) : Kaushikkumar Ramesh Patel
Date of Birth (DD/MM/YY): 18 Sep 1995 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: U1048246 Date of Expiry: 24 Oct 2029
Place of Issue: DAMAN Personal Identification Mark: Moles on forehead

(Note: If you do not have passport, you may apply for it as early as possible as passport is required for obtaining Seaman’s Discharge Certificate, mandatory for boarding a ship.)

Addresses & Contact Details -

House / Building No.: House no 35
Street /Lane: Ghelwad Falia
Village / Post Office / Tehsil: Dabhel
City / District: Nani Daman
State: Gujarat
PIN: 396210
Telephone No. with STD code: Mobile: 7874267999

Academic Record -

Class X: - Class XII: -
Year of Passing: 2011 Year of Passing: 2013
Board: CBSE Board: CBSE
English %: 70 English %: 57
Aggregate Percentage: 70 Aggregate Percentage: 66
Details of Marks Secured in (10+2) Examination -

Physics 100 71 71
Chemistry 100 82 82
Mathematics 100 53 53
English 100 57 57
Physics, Chemistry & Mathematics combined Percentage: 68.67


Diploma Specialization: Degree Specialization: Electrical Engineering
Name of Polytechnic: Name of College: Parul University
Tel. No.: Tel. No.: 9099008875
Email Id.: Email Id.:
Board: University: GTUĀ 
Year of Joining:
Year of Joining: 2013
Year of Passing: Percentage: Year of Passing: 2017 Percentage: 76
Medium of Instruction: Medium of Instruction: Gtu

Note: Diploma/Degree courses must be recognised by any State or Central Government or the AICTE.

Other Qualification, if any -

Work Experience, if any -

Name of the Firm Designation From To
Vital lab Trainee Engineer    
    16 Sep 2020  
What are your hobbies ? Cooking, playing football
What are your strengths ? Honest
What are your weaknesses ? Become friend easily

I hereby declare that all the statements made above are true and correct.

Signature of Candidate




Date ________________