1.A BLACK MOLE ON THE LEFT LEG
2.A MOLE ON THE RIGHT SIDE OF THE HEAD
Mother / Father /Guardian Name
Y Dharmaiah
Caste & Sub Caste
ST Yenadis(Sl.No-32)
Children Category
Normal
Mother / Father / Guardian occupation
COOLI
Annual Income
10000
Address:
District
CHITTOOR
Mandal/Municipality
BAIREDDIPALLE
Village/Ward
GOUNITHIMMEPALLE
Care Of
-
Building
-
Street
mekalanagireddypalle
Land Mark
-
Locality
mekalanagireddypalle
Pin Code
517415
Ration Card Number
YAP106101700167
ArogyaSri Card Number
-
Enrolment Number
//
Date: // ::
School & Class where Student studied previous year
1061007-M.P.Primary School Class:4
School & Class where Student studying present year
1038017-M.P.Primary School Class:5
Distance between Student's house and Hostel (in K.M.s)
45
Last Year Annual Examination Result
Pass
Last Year Annual Examination Percentage
59
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