r- {[-- SLC, i-side 1 8024200

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PUPIL'S RECORD SHEET

(This record sheet should be retained by the Principal ofthe school in which the pupil is studying.and shouid be til1ed up personaily
by him/her and handed over to tl.re legal guardian at the time the pupil leaves school. PIease note that it is very important lhat the
information furnished herein iqonect in a1l respects.)

Full Name of the Pupil

iltahu. nn. e..P-. fiai." - cl.<?.K.. ...,.7 .fr. A. rn.r!..l..... -.... Hr.
.... r.
S...
(As is stated in the Birth Certificate)

Date of Birth , ............*.fr...;...Q..r:.....;.,..*-*.P..1...................................Religion : ......IS .!f.r..m-

FullNameofFather/Motherorguardian,.........L4..tfi.r-14.Y*.R....!..e.bb.a........Tfr.*..hg.-.m.g-.&.. ....fir...:=e..e..k.
Permanent acldress ol Fathcr/Mother or Guarclian ,.......S..a..t..n .).-t|/.-.. ...!..1..1*:r:x..1',1...i.1..:.:r....:

Schooi
l{m j Govi. l*u:lirn t{ixsd
\urnc ()f School : f;ih$rst elv-tl Y-. -. 1.1
Date of Admission : ...2-#.P-17..:.
Date of leaving,.....2,e.!.!.. :.....1. ?.

The lasr gracle rhe student had passed :..fi.?:Adg......f..i.tf .g,.....(.*.g..).........Mcdium of Instruction: (Sffih[taflamil)
Subjects srudied in the last grade t ..**.c-e,x:A t *g ,*e......Jffn.*........71.1.a.k.."r.*
t\

DeLaiis of Sports Skills and Leadership :

Details of other Spccial Aptitudes, if any :

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Name orSchoo,, .X.n..f4t/'. l:f. G {t:{, f.

Dare of Admission: ...........,2. el.?.,..:..?.(.:...q-.3-. ........"...... Adrnission Number /'7e %l
I

Date of ieaving *A.t*......#..:*Q... cause of leaving:

Pa.uo4*,

Disabilities if any, detected at a medical examination :

Details of Sports Skills andLeadership , ...4A.ry.C.....t..

Detai1sofotherSpecia1Aptitudes,ifany:...===-.::'....:.

Date: #.
#'. e7-, Principal's Signalure :
\--l,4

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 SLC,2-side 2 8024200

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Nameor.schoor, ...*.f-.:..H)'MLYA ...*KAHL.C....C*A.H L .. /S+r" M.lt-N.^t

Date of leaving ,.3.,1.*?3.*..20-22......................Cause of leaving ,......H .....Mxt t-*xZ C-dr.P. . KsF

The last gradelhe student hacl passed : ..........f;. t.9.rE....ArJ..L . . Medium of Instruction : (€,inHa/Iami1)
subjectsstuiliedinthelastglade,*.R*\gA.+..3S.1*+|dZ*.TT.+AR-ETC&.*5firy
F-.-x
ft#}...€.,C,8.*lL
Disabilities if any, detected at a medical examination : ........lll.ilH..
Details of Sports Skills ancl Leadership , ... ..A.YmF... .!.N.

Details ol other Special Aptitudes, if an1, : ............::-=:_:....

. ... ......... ASH,SHAIII A.C.IlAs0ffI(rmu,ummui).

B.A,lofis,lIdPH'.0(R)
PRITICIPAl,
Principal's "' "' "" '1t'H{MlYAAtAEteeOttEGi"' " ' "" " "'

Name of School :

The last grade the student had passed : ..... Medium of Instruction (Sinhala,tTamil)
Subjects studied in the last grade
Concluct : .....
Disabilities if any, dctected at a n.redical exarnination

Date:

Ntires '. 1. Gracle passecl should be stated in wor-cls.

2. lnthecascofapupilchanging hisreligion, lhedatcoisuchchangeandthencwreiigionshouidbestated.
Iiorvever the Original Entrl, shouid not be deleted.
3 Thenameofguardianshouldbeenteredonlyincaseswheretheparentsarenotlivingorrvheretheydonotholdany
responsibility for pupil's educatiorr.
4' Anyskillsinsportsoranyleadershipinothcractivitiesshouldbeindicatedunclertheheading"DetailsofSportsSkillsand
Leadership".
5. The name of the pupil should be entered as given irr the birth certiflcate.

H 28646 - 50,000 (205/007) Dept of Govt. Printing