Education Department of Karnataka State
TRANSFER CERTIFICATE
(For Primary , High / Higher Secondary Schools)
School Dice No, 2-Q3 Oa 9oll 20 G No ttl)-D*
1. Name o, thc School :
Qovt l-f-p bs.-l.'oe [ -++attar,ca-t-
2. 3.
Admission No. : 1"1
ILnt,->a Cumulative Record No. 6 fO
4. Name of the Pupil in Full
Rojo
:
-ghamlqt - l<ovrnLl<- S, Sex: fg,rnJe
6. Pupil's Aadhar Card No. ; S.r.s. No. t OO -g l { L2_e 6
8 Nationality , LoA)aA 9. Religion: l.|l'l"JA 10. Caste: H o(<.Zf 11. Sub Caste :
12. Name of the Father : 13. Name of the Mother :
Aadhar Card No. : Aadhar Card No. :
14. Whether the candidate belongs to 15. Whether qualified
Scheduled Castes or Schedul6d Tribes : Y€3 for promotion : . Ye3
's-L.
16. Date of Birth (in figures and words) : i)-I o t |zo os- -frce-{,r,,eftlrd"nL@rrY Tt"lo
Place o, Birth : H ctttctr rrc cct- T\ou:ornd Jtv---
17. Standard in which the pupil was reading at the time
of leaving the school (in words) : JX fas-s
{8. ln the case of Pupil of Higher Standards
(a) Languages Studied : Ncv,rl , en$, Hir,".L
(b) Electives Studied : I.t a_11^8, Sci , J s c) v\c e
Soci
19. Medium of lnstructions , Ka"n n a-JO 24. Whether Medically
20. Date of Admission or promotion
Examined or not : Ya
25. Date of Pupil's last
to that class or standard 3olos\2.> ig attendance at school I t6lo8l2c)-o
21. Whether the pupil has paid
26. Date of which the application for the ,
all the fees due to the school : Transfer Certificate was received z o 610.) l) oz.l,
22. Scholarship if.any (nature) and period 27. Date of issue of the
to be specilied : Transfer Certificate : o 6\ og lz-r=3
28. No. of School days up
to the date of leaving : 2S-O
23. Fee concessions, if any
29. No. of School days
nature and period to be specified) the pupil attended : Bo
30. CharacterandConduct, qOOJ.
I
S rg ot th 6*ida driiisdi,.r_-nij
NOTE : The Certificate should be granted on requisition fiom pa-rent or gua ran tn case of duplicate copies on the ground
thal the orlorna! ls lost penai +ee cf ' ...: oee i" :.rs ,. :i.. Sec3._.a^/ Mult: purpose schooi and 25 Paise
