District Code: 130/ School Code :0072486

From,

SET: A-50

The Head Master / Head Mistress / Principal

TAGORE MODEL SCHOOL
SHRI MUKTSAR SAHIB
Contact Details :
Principal Name: MANINDER KAUR
Mob No.9814948472 Phone No.1633-262418

Note : Kindly Paste this slip on the envelope.

"
District Code: 130/ School Code :0072486

To,
Superintendent
Examination Branch -1
Punjab School Education Board
S.A.S Nagar, Mohali
Punjab-160062
Matriculation Examination March 2016 Open School Exam Form Details:

Starting Form No : 41113483, Last Form No : 41113483, No of Forms : 1

Note : Kindly Paste this slip on the top of the envelope.

SET: A-50


( ) 2016

SET : A-50

( )
: 0072486

: 0014056

School Name : TAGORE MODEL SCHOOL SHRI MUKTSAR SAHIB

:
: MANINDER KAUR

: 1633-262418

: 9814948472

: -

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Starting Form No : 41113483, Last Form No : 41113483, No of Forms : 1

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:..............................................

Total SC (M&B) Candidates

Total Candidates

1/1

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Punjab School Education Board

Examination (Open School) March-2016
Subject-Wise Count of Students (Centre Statement)

Matriculation

School code/Name : 0072486 / TAGORE MODEL SCHOOL SHRI MUKTSAR SAHIB

Boys: 0

Sub Code

Girls : 1

Total : 1

SET : A-50

Medium

Subject Name
Punjabi

English

Total

Hindi

Others

01

PUNJABI

02

ENGLISH

03

HINDI

05

SCIENCE

06

SOCIAL STUDIES

33

HOME SCIENCE

Signature of Two Senior Teachers of School

For Office Use Only

1......................................................
2......................................................

Verified By.............................
Signature of School Head (With Stamp)

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Punjab School Education Board

Matriculation

Examination (Open School) March-2016

Fee Details

SET : A-50

School code/Name : 0072486 / TAGORE MODEL SCHOOL SHRI MUKTSAR SAHIB

Form No

Caste

Candidate Name/Father's Name/Mother's Name

41113483

SC (M&B)

GURBINDER KAUR/PARMJEET SINGH/GURMAIL KAUR

Exam. Fee
3950

Challan Details
Challan ID

Amount

Challan Date

Bank Name

Journal Number

10321458017

3950

15/01/2016

103-PSEB HOD

319343

Total SC (M&B) Candidates

NOC

SC/BC Fee

Fee

Add Sub Fee

Late Fee

Tot Fee

Total Candidates

950

3000

3950

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Signature of School Head (With Stamp)

Punjab School Education Board

Matriculation Examination Form (Open School)
March 2016
* DO not make any correction in this form. For correction Fill Correction Performa.

For Office Use Only

Sheet No.

* Do Not Tear or Mutilate or fold This form.

ID.

10201517082
Form No. 41113483

Set

Roll No.
School Code

0072486

District Code

District Name

School Name

TAGORE MODEL SCHOOL SHRI MUKTSAR SAHIB

A-50

SHRI MUKTSAR SAHIB

Personal Information
Registration No

B-08-MKS-S-704536

Candidate Name

GURBINDER KAUR

Father's Name
Mothers Name

/
PARMJEET SINGH /
GURMAIL KAUR /

Date of Birth

13-12-1992

Category

SC (M&B)

Gender

FEMALE

Religion

SIKH

Phy. Chall.

N.A.

Area

URBAN

Nationality

INDIAN

Previous Class Details

Category

MATRIC FAIL

School / Board
Name

Roll No

1211315973

Session /Year

MARCH 2011

ggsss muktsar

Subject Details
Sr Code

Subject Name

Medium

Type

Credit Carry
Obt. Min/Max

Practical
Obt. Min/Max

1 01

PUNJABI

PUNJABI

CRC

63

33/100

74

2 02

ENGLISH

ENGLISH

CRC

42

33/100

37

3 03

HINDI

HINDI

CRC

66

33/100

45

4 05

SCIENCE

PUNJABI

CRC

52

33/100

5 06

SOCIAL STUDIES

PUNJABI

6 33

HOME SCIENCE

PUNJABI

19

10/25

C.C.E
Obt. Min/Max

32

Declaration
It is certified that information given on the form is correct and has been checked by me.

Signature of candidate

English ______________________
Signature of principal with stamp

Punjabi ______________________

Permanent Address of Candidate

Name/Father's Name : GURBINDER KAUR/PARMJEET SINGH
Address...SRI MUKTSAR SAHIB GONIANA ROAD OPP SHAMSHAN GHAT SRI MUKTSAR SAHIB...........................
Tehsil.....SRI MUKTSAR SAHIB.....District....(130) SHRI MUKTSAR SAHIB...Pin Code....152026.............
Mobile No.....8437111731........................E-Mail.......jebalwantkanti@gmail.com..............

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Punjab School Education Board

Matriculation

Examination (Open School) March-2016

School Code / Name : 0072486 / TAGORE MODEL SCHOOL SHRI MUKTSAR SAHIB

Candidate's Name

GURBINDER KAUR

Father's Name

PARMJEET SINGH

Mother's Name

GURMAIL KAUR

SIGNATURE OF CANDIDATE (in English)

@
SIGNATURE OF CANDIDATE (in Punjabi)

*13099*

Form No : 41113483

SET : A-50

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Signature of School Head (With Stamp)