H,S'C.
lndex No' 21'0125
S.S.G. lndex No. 73.0016 (GB) & Gom' Stream
lndex No. 21.0125 Science
sT, xAvlER's HIGH SCHOOL, UMRETH
S'a.)fOud ortlelei Sr. No.
1OTB5
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U-DISC-CoDE : 24150803611
LEAVING CERTIFIGATE
UMRETH-388 220Ta. Umreth. DistAnand. Ph STD' (02692)277584
[Link]./ g).[Link]. il46 Medium / rl€,qr €ut e A *
(1) Futl Nameof the students (surname First) , k AN A [Link] N n gAYe St+'FaRe
lQureII-{ gr ,rrr (uas uer, )
(2) Religion and Caste
d' ALA RAN A
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(3) Motheas Name
rtat{ ata
Per I Ro TA- P €7LAD DA- A N^^lo
(4) Place of Birth (With Taluka'District)
Yor +Esl (argsr, lt'trl +rfdct)
(5) Date of Birth (ln figure & words) : o6loEltoo+
as per Christian Celendar) 5rx ?H AUGuJ-, 7\^/o ?Hoc',|s4'JD -scv(:^l
f*+dle{ ugan'ro)idl{lul
(uissrai ui rroe)'ri)
(6) Last SchoolAftended
S?.xAVg€r's Ht-GH ScHooc uMRCrx
v?.ri ore?rt olu i 8tfl rrtslt
(7) zo lo 6l LO Z2- (8) Date of leaving School 3 tl ogJ2az
Date of Admission (Wth Class)
uQu ot{l,a (alter afBa) s10 - tv t+ crt(/lt slsut at{lu -
<1 D-12- er./c <'t A
(9) ln which standard he/she
Studying & Since when ?
N 2-o2-
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Ar? a R I - 2-o
(10) Reason for leaving school
rttot tt)srt{ stzet
(11) Progress / uctA Goo P (12)conduct/ qdels F o ot)
('13) Remark / Oclc alh : GA1 - G h z-t q2?
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(14) U.l.D. No. L4 rso
Date / dr{lu I Lt o3 [Link]
reg ister and found to be correct.
Certifv that the above informati o is verified bY me with sch ool
I
urdl virf0ta srqrqi urQ B! 6qr'0 usraell rnotat ra:cl rgrac [Link]:ll urla 0 ui
atrll 'ttclt ultr O-
Cle ?sdl : c c er q ,[ f{ras Principal / ulrll{
of the school or
make any chang es in any e ntry except the headmaster
Statutory warning ; No one ca n issue this certificate orabsence or unava ilability of t he principal
:he autho rized person aPPointe dfors uch work in the trnq sl d eqlat ut yrrutqe [Link] uai adl ! iJl s'ltl
crf&t f*qtq
[Link] utqt{ atqct ird ')rott{l'l [Link]) ufiga
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