| Basic Information |
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| Name* |
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DOB*(DD/MM/YYYY) |
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| Birth Registration Number |
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Gender* |
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| Social Catagory* |
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Religion* |
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| Mother Tongue* |
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Nationality* |
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| Aadhaar Number |
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Blood Group |
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| Identification Mark |
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| Educational Information |
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| Academic Year* |
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Admission No* |
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| Admission Date* |
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Present Class* |
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| Present Section* |
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Present Stream |
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| Present Roll No* |
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Previous Class* |
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| Previous Section* |
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Previous Stream |
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| Previous Roll No |
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Medium* |
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| If studying in class 1, Status of the previous year |
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No. of days child attended School (in the prev. year) |
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| Contact Information For Student |
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| Country* |
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State* |
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| Address* |
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Habitation or Locality* |
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| District* |
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Block* |
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| Panchayat* |
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Post Office* |
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| Police Station* |
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Pin Code* |
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| Contact No |
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Email |
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| Guardian Information |
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| Father's Name |
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Mother's Name |
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| Guardian's Name |
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Relationship |
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| Annual Family Income |
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Guardian's Qualification |
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| Guardian's Contact Information |
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| Country* |
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State* |
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| Address* |
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Habitation or Locality* |
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| District* |
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Block* |
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| Panchayat* |
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Post Office* |
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| Police Station* |
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Pin Code* |
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| Contact No |
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Email |
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| Other Information |
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| BPL Status |
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BPL No. |
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| Children with special need |
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Disability type |
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| Health ID |
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| Facilities |
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| Disadvantaged Group |
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Getting free education as per RTE Act |
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| Whether the child is Homeless |
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No of Uniform Sets Received |
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| Complete set of free books |
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Free Transport facilities |
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| Free Shoe |
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Free Exercise book |
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| Free Escort Facility |
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Free Hostel facility |
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| Special Training Facility |
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Free Bicycle |
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| Bank Details |
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| Bank Name* |
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IFSC* |
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| Branch Name* |
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Account Number* |
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| Signature of Guardian |
HOI Signature & Date with Office Seal |
