Sr.

No: ________________ File No: _______________

BOYS (Regd.) 0589

School Leaving Certificate

It is certified that __________________________________________________

S/o, D/o _________________________________________________________

Date of Birth (in figures) ____________________________________________

(In words)
________________________________________________________

Admission No ___________________________ has been student of this school

from _________________ to ________________

He / She has paid all dues of the school. He/ She read in class ______________

Section ________________ in which / she passed / Failed / During year

The following particulars are certified to be correct, according to the register of this school.

Date of Date of Period of Possible Actual attendance Leaving taken

Admission withdrawal attendance during attendance during during the during the
the current school the current school current school current school
year year year year

From To

Date of Issue

Sign. Incharge Sign. & Stamp principal