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BOARD OF SECONDARY EDUCATION TELANGANA STATE

S.S.C Public Exams March 20 (NOMINAL ROLL FORM) REGULAR / PRIVATE ONCE FAILED
Name of the School
School Category Area
(40 Characters Only)
STUDENTS STRENGTH
IN EACH X SECTION
DIST CODE SECTION CODE SCHOOL CODE U – DISE CODE PAGE NUMBER

1st Line – Candidates Name (Abbreviated Preferably Surname in order to fit in 42 Characters Only.) Date of Birth Language
Serial No.

(To be write in Blue Ink Surname First followed by candidates Name)

SECOND LANGUAGE
PHY- HANDICAPPED

PREVIOUS ROLL No
THIRD LANGUAGE

GENERAL SCIENCE
Community Code
nd

No OF SUBJECTS
2 Line – Write Father’s Name in 42 Characters.( To be write in RED Ink)

SOCIAL STUDIES
MATHEMATICS
GROUP CODE
3rd Line – Write Mother’s Name in 42 Characters. ( To be write in RED Ink)

(1,2,3, or 4)

REMARKS
Sex (B/G)

MEDIUM
MONTH
Dated

YEAR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42

P II
PI
Date: ……………………….. Note : 1. Physically Code: 1. Deaf & Dumb, 2. Blind, 3. Orthopedically, 4.Deslexia.
School Seal: 2. The Head of the Institution shall give a certificate in the form appended over leaf. Signature of the Head of the Institution
With School Stamp

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