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20081011096415
A-€cem:c year : 2019.2020
GHPS MODEL SCHOOL GIRLS GANGAVATI,II
WARD 19 GANGAVATHI
WARD 19 /, GANGAVATHI / rlorodS, KOPPAL / dro49' KARNATAKA'583227

SCHOOL TRANSTER CERTIFICATE

1. AdFrssion No,/qi,ded otatt-ra8 *oa:, 91ff-f ,%Ld 14, Standard in which the student is studying at the time of
leaving the School /
a-aeJ Eri:;sari Joeo$r t"dt,!{ dddA
8

2. Cumulative Record No. i Enrollment No./ 15. ln case of pupil of Higher Standards Promoted to /
Soaid cra:ua3 doal, dro$:crr rilradrqddl Add SodaledQ aQ
050801919 a) Languages Studied / a) er$notld draBd qDd

3, Date of Admission to School / a'lcJrl oreJet d OixdoE b) Elective Studied I a)) eduoi:d draAd o?id ndoilri$
0aa612017 MATHEMATICS,SOCIAL SCIENCE,SCIENCE

4. Name ol the Student in full / olrno6roJ: dnear dddt 16. Medium of lnstructions / zlnedd *drd
POOJA Kannada I d{d
17. Whether the Studenl has paid all the fees due
5. Sex r Ooti ard8
to School ? / raejri oa3 e<jrd ao3 zbcr*riCQ ")oarOrob
Girl / ,lr(
dn6qdotut YES

18. Fee Concession, if any (Nature and period to

6. Nationality / cn.lreod:d
be specified) / zbt-r..3aao)3 dradloadd: aqq (EdDd e$Q
indian / QadSeol:
udQo$Q $Qr{dB#dd"Q)

7. Religion / dd)F
19. Scholarship if any (Nature and p€riod to be specified) /
imdQr dedd ojred)E ldo e{q(dddra6 d)4 edQolq
Hindu / bod; Uppara / uuald
JQr{dBdd oQ)

8. Name of the Father / dodob ddcb 20. Whether Medically Examined or not /
SHARANAPPA
drdr3eob d0efi dnderohdole /eude YES

21 . Month of student last aftendance at the School I

9. Name of the Mother / 6}o1jol d$ctl 6!dd AcJi.AFob ddo! uro 6-aapnnd h.rdoE/ Sorldr
MANJAMMA
offi*Eoh tt /tl / zbzo
I C. Vvheth€r the candidate bslong6 to Schadule 22. Dale on which lhe application tor the Transfer
Caste o!'Schedule Tribe ? / Certificate was received /
i*,hrci:: dB}{ zres edaa d0}{ drlrdu dt0ddoaflqdole drordd {dran ddriro*h edrotuQ ,$oedO&d 6;o'aod

OBC l,-O,i, Category 1 / 05-JUN-2020

1i Whether qualified for promolion to a Higher Standard ? / 23. Number of School Days up to the date of leaving
d::o6iddrlSrJ uuSerarr{o9dtl odrsefl olto0:e in academic year / u-ad a)q Boaoddddfld BdrlC dod,
YES 236
24. Number of School Days the student attended in
12, Student Date of Birth / Joq,0rc&: dtld Boaod (tl{drl{Q) academic year / SrarQrob a-aeirtdnd a-otirlt' &drl* doalo
1$,OCT-2006 193

13. Plaee / dC ; GANGAVATHI /

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25. Character and Conduc,t / ddd e$Q ardOqr
Taluka / utuqdl : GANGAVATHI / rJornd8
GOOD
Oistrict / 8tl : KOPPAL / dn{S

Date of Entry Date of lssue

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ffiTf_n€$6 a

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Ir u{
Da',a Entry operator Sign e

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