
DISE CODE - 19161105107
Index No.- F2-082 * H.S. Code -06150 * VTC Code - 2041
Vill- Moula, P.O.- Ganeshpur, P.S.- Shyampur,
Dist.- Howrah, Pin No.- 711312.
Contact No.- 9732125642
Name (in Capital Letter)........................................................................................
Father's Name.......................................................................................................
Mother's Name.......................................................................................................
Name of Guardian..........................................................Relation............................
Guardian's Qualification...................................Annual Family Income....................
Address in Full.........................................................................................................
.................................................................................................................................
Date of Birth.................................................Gender................................................
BPL (Y/N)................Cast.......................................Religion....................................
Mobile No....................................................Whats App No.------------------------------
Type of Handicraft (If Applicable)...........................................................................
Admission in Class....................... Stream (If Applicable).....................................
Previous Class............................Sec..................................Roll..............................
Aadhaar card No................................................................Blood Group..................
Student's Bank A/C No.............................................................................................
Bank Nmae.........................Branch...............................IFSC ...................................
Kanyashree ID (If Applicable).....................................................................................