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नवोदय िव ालय सिमित

Navodaya Vidyalaya Samiti

( An Autonomous Body Under Ministry of Education) Government Of India

Registration No. 25140400531

Personal Detail

District in which the

candidate is studying in
class V(2020-21)
State in which the candidate is
CHHATTISGARH KOREA
studying in class V(2020-21)
Candidate is eligible for admission only in
th same district

Name of the School in which GOV. PRIMARY

Block in which the candidate is
MANENDRAGARH the candidate is studying in SCHOOL
studying in class V(2020-21)
class V(2020-21) KARIYABHARA

Name of the Candidate

ARJUN SINGH
(Name as on class V certificate)

RAGHUNATH
Mother's Name KUNTI Father's Name
SINGH

Relationship with Guardian

Name of the Guardian (Optional) KUNTI RAGHUNATH
(Optional)

Nationality of the Candidate YES Identification Mark LEFT EYE SMALL

Gender Male Category(GEN/SC/ST/OBC) ST

Medium of Examination*
(JNVST question paper will be Hindi Date Of Birth 30/06/2010
provided in this language only)

Disability,if any
(Less than 40% will not be None Disability Percentage NA
accepted)

If Others, please specify the

Religion Hinduism
Religion

Aadhar Number 890978676901 Annual Income of Parents 50000

Communication Details

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Present Postal VILLAGE PinCode 497442

Address(Residential Address is KARIYABHARA,
collected POST KACHHOUD
only for official correspondence
purpose. However
the District of class V study is the
criteria for
Registration/Selection/Admission)

Residential State CHHATTISGARH Residential District KOREA

Telephone - Mobile No. 8269986757

EmailID

Previous School Detail

III Standard Details IV Standard Details V Standard Details

Name of the State CHHATTISGARH CHHATTISGARH CHHATTISGARH

Name of the District KOREA KOREA KOREA

Name of the Block MANENDRAGARH MANENDRAGARH MANENDRAGARH

Name of the Village KARIYABHARA KARIYABHARA KARIYABHARA

GOV. PRIMARY GOV. PRIMARY

GOV. PRIMARY SCHOOL
Name of the School SCHOOL SCHOOL
KARIYABHARA
KARIYABHARA KARIYABHARA

Recognized/ Not Recognized Recognized Recognized Recognized

School Location Rural Rural Rural

Year/Month of Joining June/ 2018 June/ 2019 June/ 2020

Year/Month of Passing April/ 2019 April/ 2020

Candidate Photo Candidate Signature

Parent Signature Certificate

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