PUNJAB STATE

COUNCIL OF BASIC AND TECHNICAL EDUCATION

PUNJAB

VERIFICATION FORM
Admission Centre Name:

___________________________________________________

Student Name(In English)_______________________________

Father’s Name (In Eng.) ________________________________

Mother’s Name (In Eng.)________________________________

Date of Birth: ____________________ Class________________

Session / Year :_________________ Roll No. _______________

Registration No.__________________

Postal Address for Verification Letter / E-mail Id for Verification :

Name (Individual/Deptt.) _______________________________

Village/City_____________P.O. __________ Mohalla____________

St. No._________Tehsil___________ Distt._________________

Pin Code__________ Phone No.___________________________

Marksheet Details (If Any)

_______________________________________________________

_______________________________________________________

Signature / Signature and Stamp (if Dept.)

Note: Verified Result Card will be returned after 10 working days at urgent basis & 20 working
days at ordinary basis. After one month this section is not responsible for any claim.