Annexure – 1

Pro-forma Bill: Assessments of Students under VSE, Assam: 2020-21

Session :2020-21
Sector : RETAIL

Class / Std. :10TH Level : L-2

Exam Centre Name (In capital) : Gorajan HS school
Exam Centre UDISE Code : 18170604605
Sector (In capital) : RETAIL
Date of Assessment : 12/11/2021
Mode of Assessment (put a ‘√’ mark on the appropriate box): Online Physical
Name of Assessor (In capital) : RAHUL GAUTAM
Professional Qualification : GRADUATE
Designation : ASSESSOR
Office address : SHL INDIA PVT. LTD , 323 UDYOG VIHAR GURUGRAM HARYANA- 122016

Contact number : 8467944419

Name of Internal Examiner : DOLLY DEKA
Total number of students allowed to appear : (In words: )
Total number of students assessed : (In words: )
Total number students absent : (In words: )

DECLARATION BY ASSESSOR
THE ABOVE DETAIL IS CORRECT AS PER MY KNOWLEDGE AND BELIEF. THE NUMBER OF STUDENTS INDICATED ABOVE ARE
ASSESSED ( ONLINE / PHSICAL) BY ME AT THE RELEVANT SCHOOL / EXAMINATION CENTRE.

Signature of Assessor :

Date : 12/11/2021 Place : GORAJAN JORHAT

DECLARATION BY PRINCIPAL / IN-CHARGE / INTERNAL EXAMINER

THE ABOVE DETAIL IS CORRECT AS PER MY KNOWLEDGE AND BELIEF. THE NUMBER OF STUDENTS INDICATED ABOVE ARE
ASSESSED IN PRESENCE OF UNDERSIGNED / MY REPRESENTATIVE AT THE RELEVANT SCHOOL / EXAMINATION CENTRE. I HAVE
RECEIVED A COPY OF ATTENDANCE SHEET OF STUDENTS, COUNTERSIGNED BY ALL STUDENTS WHO WERE PRESENT AND
APPEARED FOR THE ASSESSMENT.

Signature of Principal :

Date :12/11/2021 Place : GORAJAN JORHAT

 Annexure – 2
Award Sheet for Practical Assessment under VSE Assam: 2020-21

Board of Secondary Education, Assam

Sector : RETAIL Examination Centre (School) Name: GORAJAN HS SCHOOL Examination Centre (School) UDISE Code: 18170604605

Class (Std.): 10TH Curriculum Level, on which assessed: L-2

External
External External External
Assessme External
Assessment Assessment Assessment
St Student ID 2 (Registration nt Assessment
– Portfolio – Viva
Sl. Name of the Student u number) Father’s Name – Hands
No. d on Skill
Marks (15) Marks (10) Total Marks (50)
e Total Marks in
(SSC to fill) (SSC to fill) (SSC to fill)
nt Marks (25) Words
ID (SSC to fill) (SSC to fill)
1
(A
1 Ruhit Payeng 13/PR/0152/181808/17 Ajit Payeng
2 Abhijit Dhan 13/PR/0152/230016/19 Kushal Dhan
3 Abhiraj Mundri 13/PR/0152/186335/18 Jagdish Mundri
4 Akash Jojo 13/PR/0152/230021/19 Amus Jojo
5 Akhil Sonowal 13/PR/0152/230027/19 Gobin Sonowal
6 Ankur Saikia 13/PR/0152/230023/19 Nirmal Saikia
7 Ankur Sonowal 13/PR/0152/186338/18 Jyotish Sonowal
8 Fransis Bhengra 13/PR/0152/230035/19 Mikhel Bhengra
9 Mariyanus Hassa 13/PR/0152/230018/19 Sadrak Hassa
10 Suhel Ali 13/PR/0152/186361/18 Giyas Ali
11 Baishnabi Mirdha 13/PR/0152/230056/19 Anil Mirdha
12 Bindia Gorh 13/PR/0152/186370/18 Biren Gorh
13 Binita Tanti 13/PR/0152/230063/19 Badal Tanti
14 Dibyajyoti Gogoi 13/PR/0152/230071/19 Puna Gogoi
15 Gitali Pathak 13/PR/0152/230070/19 Bipul Pathak

Name of Assessor: RAHUL GAUTAM Sign. of Assessor:

Contact no.:8467944419 E-mail id:rahul.gautam9650@yahoo.com

 Annexure – 2
Award Sheet for Practical Assessment under VSE Assam: 2020-21

Board of Secondary Education, Assam

Sector :RETAIL Examination Centre (School) Name: GORAJAN HS SCHOOL Examination Centre (School) UDISE Code: 1 8 1 7 0 6 0 4 6 0 5

Class (Std.):10TH Curriculum Level, on which assessed: L-2

External
External External External
Assessment External
Assessment Assessment Assessment
Stu Student ID 2 – Hands on Assessment
– Portfolio – Viva
Sl. Name of the Student den (Registration number) Father’s Skill
No. t ID Name
Marks (15) Marks (10) Total Marks
1 Marks (25) Total Marks in
(SSC to fill) (SSC to fill) (50)
(AA (SSC to fill) Words
(SSC to fill)
DH (SSC to fill)
AAR
16 Junali Urang 13/PR/0152/230018/19 Sadrak Hassa
17 Junuka Mirdha 13/PR/0152/186361/18 Giyas Ali
18 JyotiKunwari Aind 13/PR/0152/230056/19 Anil Mirdha
19 Kusum Sonowal 13/PR/0152/186370/18 Biren Gorh
20 Marget Lakra 13/PR/0152/230063/19 Badal Tanti
21 Mery Jojo 13/PR/0152/230071/19 Puna Gogoi
22 Nikita Barjo 13/PR/0152/230070/19 Bipul Pathak
23 Nondita Bhengra 13/PR/0152/230054/19 Jiren Urang
24 Paulin Urang 13/PR/0152/230060/19 Binud Mirdha
25 Pori Gowala 13/PR/0152/186376/18 Nikulash Aind
26 Priyanka Sonowal 13/PR/0152/230069/19 Kinai Sonowal
27 Ruksara Banu Begum 13/PR/0152/230078/19 Fuljen Lakra
28 Sarita Suman Herenj 13/PR/0152/230049/19 Jushap Jojo
29 Tajmin Begum 13/PR/0152/186384/18 Pramud Barjo
30 Tutumoni Mirdha 13/PR/0152/230062/19 Piuse Bhengra

Name of Assessor: RAHUL GAUTAM Sign. of Assessor:

Contact no.:8467944419 E-mail id:Rahul.gautam9650@yahoo.com

 Annexure – 3
Attendance sheet for Practical Assessment under VSE Assam: 2020-21

Board of Secondary Education, Assam

Examination Centre (School) Name:GORAJAN HS SCHOOL Examination Centre (School) UDISE Code: 18170604605

Date: 12/11/2021 Sector: RETAIL Class (Std.): 10TH Level: L- 2

Stud Student ID 2 Name of Student Father’s

Sl.N Name of Student Signature of
ent ID (Registration no.) Name
o. Students
1
(AADH
AAR
1 13/PR/0152/181808/17 Ruhit Payeng Ajit Payeng
2 13/PR/0152/230016/19 Abhijit Dhan Kushal Dhan
3 13/PR/0152/186335/18 Abhiraj Mundri Jagdish Mundri
4 13/PR/0152/230021/19 Akash Jojo Amus Jojo
5 13/PR/0152/230027/19 Akhil Sonowal Gobin Sonowal
6 13/PR/0152/230023/19 Ankur Saikia Nirmal Saikia
7 13/PR/0152/186338/18 Ankur Sonowal Jyotish Sonowal
8 13/PR/0152/230035/19 Fransis Bhengra Mikhel Bhengra
9 13/PR/0152/230018/19 Mariyanus Hassa Sadrak Hassa
10 13/PR/0152/186361/18 Suhel Ali Giyas Ali
11 13/PR/0152/230056/19 Baishnabi Mirdha Anil Mirdha
12 13/PR/0152/186370/18 Bindia Gorh Biren Gorh
13 13/PR/0152/230063/19 Binita Tanti Badal Tanti
14 13/PR/0152/230071/19 Dibyajyoti Gogoi Puna Gogoi
15 13/PR/0152/230070/19 Gitali Pathak Bipul Pathak

Name of Assessor: RAHUL GAUTAM Sign. of Assessor:

Contact no.: 8467944419 E-mail id: Rahul.gautam9650@yahoo.com

Sign. Of Principal / In-Charge / Internal Examiner (with seal):

Note: In case of assessments, conducted in ‘online’ mode, Principal / In-Charge / Internal Examiner (Trainer) is requested to get this
sheet – Filled by students, sign, apply stamp and share scanned document with Assessors, via email
 Annexure – 3
Attendance sheet for Practical Assessment under VSE Assam: 2020-21

Board of Secondary Education, Assam

Examination Centre (School) Name: GORAJAN HS SCHOOL Examination Centre (School) UDISE Code:18170604605

Date:12/11/2021 Sector: RETAIL Class (Std.):10th Level:L-2

Studen Student ID 2 Name of Student Father’s

Sl.N Name of Student Signature of
t ID 1 (Registration no.) Name
o. Students
(AADHA
AR no.)
16 13/PR/0152/230054/19 Junali Urang Jiren Urang
17 13/PR/0152/230060/19 Junuka Mirdha Binud Mirdha
18 13/PR/0152/186376/18 JyotiKunwari Aind Nikulash Aind
19 13/PR/0152/230069/19 Kusum Sonowal Kinai Sonowal
20 13/PR/0152/230078/19 Marget Lakra Fuljen Lakra
21 13/PR/0152/230049/19 Mery Jojo Jushap Jojo
22 13/PR/0152/186384/18 Nikita Barjo Pramud Barjo
23 13/PR/0152/230062/19 Nondita Bhengra Piuse Bhengra
24 13/PR/0152/230055/19 Paulin Urang Junput Urang
25 13/PR/0152/186387/18 Pori Gowala Sanatan Gowala
26 13/PR/0152/230065/19 Priyanka Sonowal Nitul Sonowal
27 13/PR/0152/230046/19 Ruksara Banu Begum Romjan Ali
28 13/PR/0152/186397/18 Sarita Suman Herenj Simon Herenj
29 13/PR/0152/186401/18 Tajmin Begum Bhaijan Ali
30 13/PR/0152/230059/19 Tutumoni Mirdha Anil Mirdha

Name of Assessor: RAHUL GAUTAM Sign. of Assessor:

Contact no.: 8467944419 E-mail id: Rahul.gautam9650@yahoo.com

Sign. Of Principal / In-Charge / Internal Examiner (with seal):

Note: In case of assessments, conducted in ‘online’ mode, Principal / In-Charge / Internal Examiner (Trainer) is requested to get this
sheet – Filled by students, sign, apply stamp and share scanned document with Assessors, via email