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Full Name of Student

Mother's name

Gender
GenderMaleFemale

Race and Caste

Nationality

Aadhaar No.

Mother Tongue

Place of Birth

Date of Birth

Date of Birth in words

Issue Number
Issue Number1st2nd3rd4th5th

Relation with Pupil

Parent's Occupation

Annual Income

Parent's Full Name

Home Address

Phone Number

Phone Number

This is to certify that Information provided is correct to the best of my knowledge.

Place

Date