SLC No.

10633957
High School
School Name : ADARSH HIGH SCHOOL SATROD KHAS
Block : Hisar - I District : Hisar
UDISE Code : 6120604504 Department School Code : 22034

SCHOOL LEAVING CERTIFICATE

( Academic Year: 2016-2017 )

File No. 353 Date of issue 04-Apr-2017

Pupil's Name Ms. JYOTI

Date of Birth 27-Sep-2002
Student Registration No. (SRN) 1604718459 No. in Admission Register 1342

Name of Father/Guardian Mr. SHYAM LAL

Mother Mrs. SARITA DEVI

Certified that Ms.JYOTI attended this school up-to 04-Apr-2017. He/she has paid all sums due to
the school, and was allowed on the above date to withdraw his/her name. He/she was reading in
Class Eighth in this school.

1. He/she was examined in Eighth and

a. Was allowed/promised promotion to Class ,

b. Passed the examination in the highest class available in the school, OR
c. Left the school mid-session to join a different school, OR
d. Failed in subject(s)
Note: (please tick and fill whichever is applicable)

The following particulars are certified to be correct according to the registers of the school and the
certificate's produced from previous school attended during the school year:
No School Date of Date of Date of No. of total Pupil's Leaves taken
Admission withdrawal attendance attendances attendance during the
during the during the during the current
current school current current school year
year school year school Year
1 ADARSH HIGH 01-Apr-2016 04-Apr-2017 01-Apr-2016 279 0 0
SCHOOL To
SATROD 04-Apr-2017
KHAS

Date of issue 04-Apr-2017 Signature and seal of Head Institution

 SLC No. 10633957

For Scholarship-Holders Only

Kind of scholarship Value Year of award

Date up-to which drawn . By whom payable

Note: Entries checked and found correct:

Signature and seal of Head Institution

For office use only:

Certified that Ms. JYOTI S/o-D/o- ward of Mr. SHYAM LAL and a student of the Eighth class

who left the ADARSH HIGH SCHOOL SATROD KHAS School (School Code 22034 ) Hisar -

I Block, Hisar District with Transfer Certificate No. 10633957 Dated 04-Apr-2017 has joined the

class Of School (school code

), District on His/her date of birth mentioned in

the Transfer Certificate is 27-Sep-2002.

Signature and seal of Head Institution