You are on page 1of 2

STUDENT’S PERSONAL INFORMATION AND IDENTIFICATION

(Please fill up in BLOCK letters)

Student Id:

Student's Name: ALEENA ROSE ANTONY


Students's Baptismal Name: ROSA
Family Name: MOOLAN
Date of Birth (DD/MM/YYYY) 28/April/2005
Date of Baptism (DD/MM/YYYY) 07/August/2005
Gender: (Male/Female) : FEMALE
Name of the Regular school: MITRA ACADEMY
Home Telephone: -

Present Address: #G1, A-BLOCK, ARVIND SOWPARNIKA, 1ST MAIN, 1ST CROSS, SHA

Ward: AREKERE

Father's Name: ANTONY M. P.


Email ID: antony_moolan@yahoo.com

Mother's Name: MINI K. V.


Email ID: minikv_moolan@gmail.com
MATION AND IDENTIFICATION
BLOCK letters)

Std and Division: X

Blood Group : O+VE


Board: ICSE

RVIND SOWPARNIKA, 1ST MAIN, 1ST CROSS, SHANTINIKETHAAN LAYOUT, AREKERE, BENGALURU-560076

Parish Family Book Number:

Contact No: 9900036430

Contact No: 9535573226

You might also like