RUKMANI BIRLA MODERN HIGH SCHOOL-X

Name of student VANSHITA TOTLA Name of Father: VIVEK TOTLA

Name of Mother: RASHMI TOTLA Gender: Female
Category Gen Subject 1: Eng. Lang. and Lit.
Subject 2: Hindi Subject 3: Mathematics
Subject 4: Science Subject 5: Social Science
NSQF Subject IT-402 Annual Income 3200000
Date of Birth 23062005 Only Child N
(DDMMYYYY)
Admission Number 2517 Admission Date 03012009
(DDMMYYYY)
Minority: N Email Address RASHMITOTLA06@GMAIL.COM
Mobile Number 9660222888 Aadhar Card No. 857342505868

Checked and Verified by- Name of Class Teacher and Signature:

___________________________________________________________________________________________
Undertaking
I have thoroughly checked and verified all the above-mentioned details of my ward for the CBSE Examination of
Class X 2020-21. I am solely responsible for any changes that may or may not be detected after this careful scrutiny
and registration done by the school.
Signature of Father:
Signature of Mother:
Signature of Student:
Date:
Dear Parent
• This form contains the details that you have filled at time of CBSE Registration in class IX.
• If your ward comes under the category of SC/ST, provide relevant certificate for the same issued in the
name of the student by the concerned department.
• If your ward comes under the category of OBC, provide latest certificate for the same issued in the name
of the student by the concerned department.
• No changes in any data will be considered in the above filled form.
• Download this page and verify all details carefully.
• Take a printout of page.
• Do signatures where required. (Signatures are mandatory for father, mother and student)
• Scan the document after verifying and signing. Mail it on rbmhsclassxloc@gmail.com by 10/06/2020.

Principal