G0VERNMENT OF KERALA

DIRECTORATE OF GENERAL EDUCATION (HIGHER SECONDARY WING)

APPLICATION FOR ADMISSION TO THE HIGHER SECONDARY COURSE (2O23-2O24)
APPLICATION NO: 2313101152

Name: ANAMIKA C Guardian Name: AJITHA C

Mother's Name: AJITHA C Father's Name: RAMESHAN P P

Date of Birth: 20-12-2007 Sex: Female

Aadhaar No: 666XXXXXX011 Enrolement No: -

Board Passed: Yes Scheme: SSLC (2022-2023) Register Number: 490822

Month of Pass: 3 Year of Pass: 2023

Category Name: EzhavaThiyyaBillava (ETB) OEC: No

Caste: THIYYA Religion: Hindu

Resident State: Kerala Resident Local Body: Vengad

Resident District: Kannur Resident Taluk: Thalassery

Permanent Address: PUTHAN PURAYIL HOUSE,KUZHIYIL PEEDIKA Communication Address : PUTHAN PURAYIL HOUSE,KUZHIYIL PEEDIKA

PATHIRIYAD P O,670741,KANNUR. 670741 PATHIRIYAD P O,670741,KANNUR. 670741

Blind: No Deaf No OH: No

IEDC : - MR/Brain Diseases: No Health Club: No

Linguistic Minority: No Minority Language: Jawan Killed In Action: No

Jawan Priority: No NCC or Scout / Guide(Puraskars) No Scout / Guide Participation : No

NTSE Qualified: No NMMSSE Qualified: No USSE Qualified: No

LSSE Qualified: No Student Police Cadet: No Red Cross: No

Forestry Club: No Environment/Nature Club: No IT Club: No

Maths Club: No Debating Club: No Philatery Club: No

Oratory Club: No Science Club: No Social Science Club: No

Grace Mark Awarded: No Little KITES Members With A Grade: No

SPORTS AND YOUTH FEST SL-I D-I / A D-II / B D-III / C DLP STATE FAIRS A-Grade B-Grade C-Grade D-Grade E-Grade

Sports Fest 0 0 0 0 0 State Science Fair 0 0 0 0 0

Youth Fest 0 0 0 0 0 State Social Science Fair 0 0 0 0 0

E-Mail ID: sthrvv78@gmail.com State Maths Fair 0 0 0 0 0

Phone Number: 9645699778 State IT Fair 0 0 0 0 0

Chance Number: 1 State Work Experience Fair 0 0 0 0 0

SSLC School: 13054 MAMBRAM HSS,MAMBRAM,KANNUR

State Level First(SL-I), District First or A-Grade(D-I / A), District Second or B-Grade(D-II / B), District Third or C-Grade (D-III / C), District Level Participation(DLP)

CANDIDATE GRADE DETAILS

PAPER NAME MARK GRADE GRADE POINT

First Language- I NA A+ 9

First Language- II NA A+ 9

English NA B 6

Hindi NA B 6

Social Science NA B+ 7

Physics NA C 4

Chemistry NA C 4

Biology NA C+ 5

Mathematics NA C+ 5

Information Technology NA A 8

IT Services : NIC Kerala Page 1 / 2 IP : 103.140.16.28 - Date & Time : 02/06/2023 06:30:31 PM
 CANDIDATE OPTION DETAILS (MAIN)

Pref School Code Course Pref School Code Course Pref School Code Course Pref School Code Course

No. Code No. Code No. Code No. Code

1 13013 10 7 13040 11 13 13010 10 19 13127 12

2 13012 33 8 13040 39 14 13003 10 20 13111 34

3 13015 10 9 13064 21 15 13160 34 21 13071 11

4 13059 11 10 13064 36 16 13180 11 22 13020 11

5 13039 16 11 13061 39 17 13166 10 23 13038 39

6 13015 39 12 13021 11 18 13165 11 24 13054 39

.......................................................................................................................................................................................................
DECLARATION
I AJITHA C, Parent of Master/Kumari ANAMIKA C do hereby declare that all the information furnished in the application are
true to the best of my belief. I know that the allotment got by any false information furnished in the application will results in the
cancellation of Allotment and Admission.

Name and Signature of Parent/Guardian

Place :
Date : 02-06-2023

IT Services : NIC Kerala Page 2 / 2 IP : 103.140.16.28 - Date & Time : 02/06/2023 06:30:31 PM