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KHAGRIBARI GOVT. PRIMARY SCHOOL
PUNDIBARI CIRCLE ● COOCHBEHAR
STUDENT’S DCF: .......................................
1. NAME OF THE STUDENT: …………………………………………………..
2. D.O.B: .....................................
3. FATHER’S NAME: ……………………………………………………………...
4. MOTHER’S NAME: …………………………………………………………….
5. GUARDIAN’S NAME: ………………………………………………………….
6. MOBILE NO.: ......................................................
7. GENDER: MALE / FEMALE: .............................
8. OCCUPATION: ...................................................
9. RELIGION: HINDU/ MUSLIM : ...........................
10. CATEGORY: SC / GENERAL: ............................
11. AADHAAR NO.: .................................................
12. ACADEMIC YEAR : .........................
13. ADMISSION NO. : ......................... DATE: .............................
14. CLASS : ............... ROLL NO. ..............
15. VILLAGE: ..........................................................
16. P.O : ..................................................................
17. G.P. : .................................................................
18. P.S. : PUNDIBARI
19. DIST. : COOCHBEHAR
20. PIN: 736165
Signature of Guardian’s