1.A BLOCK MOLE ON THE RIGHT ARM
2.ABLACK MOL ON THE RIGHT SAID Eye
Mother / Father /Guardian Name
D NAGESH
Caste & Sub Caste
ST Yerukulas(Sl.No-33)
Children Category
Normal
Mother / Father / Guardian occupation
COOLI
Annual Income
35000
Address:
District
YSR KADAPA
Mandal/Municipality
YERRAGUNTLA
Village/Ward
YERRAGUNTLA
Care Of
-
Building
-
Street
-
Land Mark
-
Locality
-
Pin Code
516309
Ration Card Number
WAP112401100028
ArogyaSri Card Number
-
Enrolment Number
//
Date: // ::
School & Class where Student studied previous year
1124602-Z.P.High School Class:7
School & Class where Student studying present year
1124602-Z.P.High School Class:8
Distance between Student's house and Hostel (in K.M.s)
3
Last Year Annual Examination Result
Pass
Last Year Annual Examination Percentage
Achievements in Extracurricular activities
-
Is the Student Physically Challenged
NO
Is the Caste Certificate verified by the School Head Master :
YES
Is the Income Certificate verified by the Village Revenue Officer/Gazetted Officer :
YES
Are the above details verified by the Hostel Welfare Office :
YES
The above details are verified according to the rules and regulations of Government policies and the application form of applicant is accepted/rejected :
YES