Adobe Scan May 03, 2022
Adobe Scan May 03, 2022
Adobe Scan May 03, 2022
10. Blood
Group ot 11.Health ID
12. Identification Mark:
B. Educational Information
1. Academic Year 2 0 2 223 (20XX-xx) 2. Admission No":
3.
Admission Date":5 o
4. Present Class* 3 5. Present Section* 6.
8.
Present Roll No*: |7. Present Stream
Previous Class*:
9. Previous
Section*:C10. Previous Roll No: \-11.
12. Medium Previous Stream:
13. If
:English
studying
in class 1, status of
previous year
14. No. of days child attended school
C. Contact Information:
1.
2.
Address
Habitation or Locality*
:KANAINATSAL SRIPALLY, BURDWAN
:NEHR GJATERTANK ORD-2
3. District PURBA BARDH AMAN
4 Block/Muniipality :MUNLCIPALIEY PURBABARDHAMAN
5. Panchayat
6. Post 0ffice SRIPALLY
7. Police Station*
BURDWAN POLI CE STATLON
8.
9.
Pin Code
Contact No.
713 N3
91 9 6 4 547 N
10. Email
:dtumo2555aama?l.Com
D. Guardian's Details:
1. Father's Name BASUDEV DUTTA
2. Mother's Name RVMA DUTTA_
3. Guardian's Name BASU DEV DUTTA_
4. Relationship(with Guardian)" FATHER
5. Annual Family Income :Hboe 5,o0, O00
6. Guardian's Qualification (nRADVATE
Page 1
Ver.: 1.0
[Release Date: 22.02.2019]
Guardian's Contact Information:
1. Address
2. Habitation or Locality KANAINATSA- SRIPALLY,BURDWAN
3. District
NERR WATER TANK
4. Block/ Municipality PURBABARDHAMAN
5. Panchayat MUNTCI PALL TY PURBH BARDHAMAN
6. Post Office
7. Police Station SRIPRLLY
8. Pin Code
BURDWAN POLICE STATION
9. Contact No. 7H3O3
10. Email
91 9o 64 54
: douma555 Qavnoil. Com
F. Other Information:
1. BPL Status
IF Yes 2. BPL No.
3. Children with
special need: NO0 ,If Yes, 4. Type of Disability: No
G. Facilities:
1. Disadvantaged Group
:NO 2. Getting free education as per RTE Act: NA
3. Whether the child is Homeless:
NA 4. No of Uniform Sets Received
NONE
5. Complete set of free books NONE 6. Free Transport facilities
No
7. Free Escort Facility NA 8. Free Hostel facility NA
9. Hostel Type NA 10. Hostel Schemes NA
11. Special Training Facility :NA 12. Remarks NO
13. CWSN Facility Received NA 14. Free Bicycle No
15. Free Shoe ND 16. Free Exercise Book
NO
H. Bank Details:
1. Bank Name CANARA BANK
2. Branch Code o 3
3. IFSC
4. Account Number
cNRBoo 03
9 3 o o3 3 9
For the Students of grades IX to XII who have opted for Vocational Courses:
1. Trade/Sector
2. Job Role
3. Completed NSQF Level N
4. Employment/Placement Status
5. Salary Offered
Compiled by
Approved by
Compiled on:
Page 2
Ver: 1.0
[Release Date: 22.02.2019