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 '.i I'J c dlange in any entry in this certificate shall be made except by the
nfrngement of this requirement is liable to invoie the imposition of penalty such

SHREE M.T.I. VIDH

LEAVING CERTIFICATE
SS C INDEX NO, 55.013 H.S.C. TNDEX NO. 27.097

ieaving Certifrcarc no l2O f lat Pupils Regi. No ,59-A

Name of the pupil beginning with surname

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Rat{i{ 1+ urr: (uar uuret"t.Il) Pornnoo Aho*kraEaO ,Af.ri..,,
2. Race and Religion Sch. Cast tribe & So. &
Ed. B.C. recommended by Baxi punch
,.. q,r ui ati ,{t r,r q"[, uqqt{ t.tnh ui qe{l fiiad-u T}eltos
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3 Place of Birth, Wth Taluka & Dist
t.rrolR atga lt<<rt *rl0* Qobh"ao, To 4
4 Date of Birth Month and Year ";o.
According to Christain Era in Figures & Words
r. rldl{t un el r..r.u{lq, rutt q'lq{
: -.rsi schooi attended p ig. Q*dhauga,t
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6lni fvtn.v- Dqblnoda.
II o. oate of aomission (with standard) a6,-|de; a3 itA;.yg-<Aavc-456;-
e. e,rttq qqr.{l ar{lq trh$ ttBa
7. Progress 9. r,ior{t+
Aoa4
I Conduct l. rttctil(intd
9004
D6te of Leaving School
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'0 Standard in which studing & since when ? €Hd. Xtr Crare4w-6'3ffie-itqAa:6
to. flr tittqtql rrorar+t rl d u-r sqtrrll ?
11 Reason of leavino School
r r. lirue ui lur{ srrei Coqoeleted H,9.c Cbcu*e
l2 Attendence (No of days)
i '.. gtry. Bq+t
i3. Fees due to the school paidornot? in st during of the School year_ out of
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'4 Remarks r;r. e'rfi
g€rtt+ LtP t+.s.c -6niq-wd4
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Certified that the above information is in accordance with schoot register
Dated

erl6llt

Librarian Class Teacher

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