You are on page 1of 2
aA: 8. 10 30,000/ 4-2016 ween Gv. 185/— wa Upp 8 40/— AM Ta Yew F, 50/— werc 8. 10/— Ria Te 10/— 13361 gan: wae 2 aed Rest ay vt Pet ot oe we a torent Glee] Exam Centre Exam Roll No. 1, wer or qT art (fet 4) : ‘ST 7 (in block letters) Name of the Candidate (As per school records) = Sane OO" CT pebtel £ Lyeomnem Date of Birth 3. far ar am (feet 4) Father's Name (sittoft 4) {in block letters) 4. aBerfh or aT ar Aid A wy eR FA 1 we Kiva wR) Postal Address (in block letters) "ESTATE @)/ EXEMPTION APPLICATION - FORM (FROM MADHYAMA) 7. ag fem é ager dam ww a aie ah or fla : ....... (Attested) (ereftege ufafeft aft aa wet @) Prat Yer 8 75/—, wet VA OT EM ¥. 6/— |e ®. 00/—, Rela Yew v. 10/— (88 wth ‘ormae awa — 5 We a we |) nitenlt owe ae ogo TAR oe sees fear 8 1 ola wh Parr we eT BH. em (TNo.) Name of the Pracharak : (PNo.) Phone No. wa PST 7 8 area Ye dere ar ae, aed Her vas A Shar &, Sere fore GT aAReE | meray er H oeieh at or wet awn ene wa a tar ey | aa ey oR Uden wet Vet SITET | oreer—aa, Peart yew aft op 15/— fae 15 Tw oer ar Prem eee | ate or Raeia Yoo afer 25 /fereaR 25 a Ue Rear wy Prorat mE ig Fret Ge 1 2 Wawra, ar Age ar Tema. ween 4 feed fea dae auftert Bra, aria flerra a adtea faerra a Widget, aA onodi oer § fata ae & wr A feed cay viet shen 4 aeitol era aT ara Pah fawa H 50% sie mT Bra; wad ar onedl ofere when A wert at & wa 4 feet dae eiph ofan Foci ura aT ara feet fava H 50% si ut BTA; eas, ar GPRR SPro ohana A AR dew ipl shar F-sehet wre ar aA Bret Faye A 50% af Be BTA, Pret ah Peatteraa & saeRe, shee crefeoeae, arm war A wee ote H weil ora, Bes RTE aT Fe ser wae A ie Ay eer we aA ora, eG am 8 teh we Sent ors atta fet Peete A oRaa ohn Ah octet wr, shat oan 3 Gee oS wu HRN Re dow eae Aas BO = fem No. 10 fay Ea S ye gangs 8 gq STA | FAM—Va OIG aR site wa arr torn sitar # A aK wa Al oer A fe aI ad we aR PR deny ear Re | conten fan } ogee warm a ae aA ara@ ones aT ome SATO oT ais Ht ST eft (Atested) oA TA Wen aeHos doar aay vies #1 WE Yeo $ wer onder Va BT ams. 5/— Ato Tee e | form anteat a ae Te ah, sre aera tot STAT she Weer S pepe T 4s Pel siee sear far Sar Utero ES oe SM oT ee AM Te | ‘waet—e_ www.hindisabhatrichy.com we santa fran are | tet—wet & fsa # aten—ferrr wr Pefa a sifeer eta |

You might also like