UDISE FORM

New Era High School

Parents/Guardians are requested to fill up the given form in capital letters and submit it to office
by tomorrow ,in case if you are out of station then submit this form as soon as you arrive Patna ,
Thanks

Class:- ________ Section:- _____ Roll No. _____ Admission No. _________
(1) Student's Name (as per School Record) :- ____________________________________________

(2) Gender :- _________________

(3) Date of Birth (DD/MM/YYYY):- __________________

(4) Student Code/ID (as per State) :- ____________________________

(5) Mother's Name :- ________________________________________________________________

(6) Father's Name :- ________________________________________________________________

(7) Guardian's Name :- ______________________________________________________________

(8) Aadhaar Number of Student :- _____________________________________________________

(9) Name of Student as per/in Aadhaar Card :- __________________________________________

(10) Address ______________________________________________________________________

______________________________________________________________________________

_____________________________________________________________________________

(11) Pincode __________________

(12) Mobile Number (of Student/ Parent/ Guardian) ______________________________________

(13) Alternate Mobile Number (of Student/ Parent/ Guardian):- _____________________________

(14) Contact email-id (of Student/Parent/Guardian) :- ____________________________________

(15) Mother Tongue of the Student :- _______________________

(16) Social Category :- _____________

(17) Minority Group :- _____________

(18) Whether BPL beneficiary? :- _______________ Yes ( ) No ( )

(19) Whether Antyodaya Anna Yojana (AAY) beneficiary? :- ________ Yes ( ) No ( )

(20) Whether belongs to EWS / Disadvantaged Group?:- ___________ Yes ( ) No ( )

(21) Whether CWSN? :- _________ Yes ( ) No ( )

(22) If Yes, (a) Type of impairment (code) :- __________________

(23) Whether the Student is Indian National?:- ________________ Yes ( ) No ( )

(24) Is this Student identified as Out-of-School-Child in current or previous years? ________

Yes ( ) No ( )

(25) When the student is mainstreamed? :- ____________________

(26) Admission Number in School ____________________________

(27) Admission Date (DD/ MM/ YYYY) in Present Class _____________________

(28) Class/Section Roll Number _____________________________

(29) Academic Stream opted by student (For Higher Secondary Classes only) ______________

(30) Status of student in Previous Academic Year of Schooling(2021-22) __________________

(31) Grade/Class Studied in the Previous/Last Academic Year (2021-22) __________________

(32) Admitted / Enrolled Under (Only for Pvt. Unaided) ________________________________

(33) In the previous class studied – whether appeared for examinations:- _________________

(34) In the previous class studied – Result of the examination:- __________________________

(35) In the previous class studied – Marks obtained (in Percentage):- _____________________

(36) No. of days Student attended school (in the previous academic year):- ________________