s;dhe [dk

Application Form $ noih ckow

Issuance of Duplicate Certificate cum Result Card

gk;goN

v[gbhe/N ;oNhfce/N ikoh eoBk ew Bshk ekov b?D bJh

Notification Service No :- 162 a
(o{oh jdkfJsK fgSb/ gzB/ s/ gVQ)

BNhfce/B ;oft; Bza 162 J/

:- 20 Days

Stipulated Time

BN L u?Z e fb;N nB[;ko ckow u?Z e eo fbnk ikt/.

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ch; 600$-o[gJ/ gqsh ;oNhfce/N

; X ch; 1000$- o[ gJ/ gqs h rbsh
ch; dk t/ otk

fibQ/ dk BK

vkfJoh Bz aaaaaaaaaaaaaaaaaaaaaaaaaaa

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gqhfynk
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fgsk dk BK aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
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Student Details in English (IN CAPITAL LETTER)
Name
Fathers Name
Mothers Name
Reg. No.
Date of Birth

Aadhar No

Mobile No

Phone No

STD Code

School Name

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T[goes sZEK ftZu eJh rbsh gkJh iKdh j? sK w?A y[d fizw/tko jtKrk$jtKrh ns/ w?A ckow ;woZE nfXekoh sA jh s;dhe eotk fojk$ojh jK.
gqhfynkoEh d/ g{o/ j;skyo (nzro/h ftZu)

gqhfynkoEh d/ g{o/ j;skyo (gzikph ftZu)

s;dhe
w? s;dhe eodk$eodh jK fe w? fpB?eko B{z ikDdk$ikDdh jK ns/ fJj n;b gqhfynkoEh j?, fi;dh cN
s;dhe eo fdZsh rJh j?. fpB?eko B/ w/oh jkoh ftZu j;skyo ehs/ jB.
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(dcsoh wjo)
e/t b dcsoh tosA bJh

ikoh ;oNhfce/ N ew Bshk ekov

dk bVh Bzp o

ckow ftZu doi ehs/ t/ot/ ns/ nvzvk

eohizvk th gVskb/ rJ/ jB.

(1) ;oNhfce/N
(2) Bshk ekov

vhaJhaUa$i{a ;jkfJe

gZso ftjko bJh BK ns/ g{ok gsk

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;oNhfce/ N G/ i D dk t/o tk
ofi;Nov Bza
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fwsh

gZso ftjko bJh BK ns/ g{ok gsk

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***** ezfgT{No ;? Zb *****

ckow GoB ;pz X h jdkfJsK

1)
2)

3)

4)

5)

6)
7)
8)
9)

10)

tZy-tZy gqhfynktK (ebk;K) bJh nbZr-nbZr ckow Gfonk ikt/ .

fpB?eko ckow ftZu ;ko/ t/ot/ fit/A nkgDh iBw fwsh, BK, wksk$fgsk dk BK ns/ ofiNq/;B Bzpo nkfd fXnkB
Bkb fpBQK fe;/ efNzr sA Go/rk. ckow ns/ cN fJe jh ;woZE nfXekoh tZbA s;dhe eotk e/ G/i/ ikD. eJh th
ftnesh fe;/ jo tZbA fpB? gZso$ckow Bjh d/ ;edk. fJj ckow n;b gqhfynkoEh tZbA jh Goe/ G/fink ikt/.
ckow ns/ c N s;dhe eoB tkb/ ;woZE nfXekoh.
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gzikp ;e{b f;Zfynk pov d/ w?Apo iK ;jkfJe ;eZso iK T[; d/ pokpo iK T[Zgob/ nfXekoh, n?ri?efNt
w?fi;No/N, ;oekoh$wkBsk gqkgs (J/fvv) ;e{bK$ekbiK d/ w[Zyh, gzikp oki dhnk :{Bhtof;NhnK d/
gqc?;o, ;hBhno ;?ezvoh (12thA q/Dh) bJh ;oekoh$wkBsk gqkgs (J/fvv) ;hBhno ;?ezvoh ;e{bK$
ekbiK d/ w[Zyh ns/ vhaghankJha d/ vkfJo?eNo$fvgNh vkfJo?eNo$;jkfJe vkfJo?eNo.
n)
fibQk f;Zfynk nc;o iK ;oeb f;Zfynk nc;o, Gkosh ;?fBeK s/ T[jBK d/ pZfunkA d/ e/; ftZu :{fBN d/
nfXekoh ns/ n?chbhJ/fNv ;e{bK d/ w[yh e/tb nkgD/ ;e{bK d/ ftfdnkoEhnk d/ ckow jh s;dhe
eoBr/.
(J)
T sA fJbktk pkjob/ okiK d/ fpB?eko nkgD/ ckow nkgD/ fibQ/ d/ fibQK f;Zfynk nc;o$n?r?efNt
w?fi;Nq/N$sfj;hbdko sA th s;dhe eotk ;ed/ jB.
(;)
fgSb/ fJZe ;kb ftZu gqhfynk gk; eoB tkb/ T[whdtko e/tb nkgD/ ;e{b$ekbi w[Zyhnk sA ckow
s;dhe eotk e/ G/iD.
(j)
gzithA /qDh dk d[gosh ;oNhfce/N b?D bJh d[gosh ckow ns/ ;pzXs ;e{b d/ dkybk ofi;No dh cN
ekgh pbke gqkfJwoh f;Zfynk nc;o sA s;dhe eotk e/ G/ih ikt/.
(-) uzv hrVQ d/ ftfdnkoEhnK bJh LT sA fJbktk fbQk f;Zfynk nc;o ns/ uzvhrVQ fty/ ;fEs ;oekoh$wkBsk gqkgs (J/fvv) $ekbiK d/ w[Zyh.
ch; L(T)
pDdh ch; pov d/ w[Zy dcso ftZu e?hno gk; iwQK eotk e/ ckow Bkb n;b o;hd brkJh ikt/.
iK
pDdh ch; p?Ae vokcN okjhA th ;eZso, gzikp ;e{b f;Zfynk pov d/ Bkw i n?;a J/a n?;a
Bro$uzvhrV fty/ ndk jD :r jt/, G/ih ik ;edh j?. wBhnkovo$g;Nb nkovo okjhA G/ih
ch; ;theko BjhA ehsh ikt/rh/.
i/eo 20 fdBK d/ nzdo ;oNhfce/N ew Bshk ekov gqkgs Bjh j[zdk sK gzikp ;e{b f;Zfynk pov, ftZfdnk
GtB, c/i-8, n?;aJ/an?; Bro (wjkbh) 160062 dh d[gosh ;oNhfce/N Bkb ;pzXs kyk Bkb g{o/ t/oftnK
;fjs gZso ftjko ehsk ikt/.
;kb 2001 sA gfjbK d/ BshfnK dhnk Bshk hNK T[gbZpX Bk jD eoe/ nzeK ;fjs Bshk ekov BjhA G/i/ ik
;ed/, fJ; eoe/ e/tb T[whdtko tZbA bJ/ ftfnk ftZu gk; iK c/bQ jh do;kfJnk ikt/rk.
so[ZNh tkb/ e/;K ftu gqhfynkoEh tZbA so[ZNh d{o eotkT[D T[gozs jh d[gosh ;oNhfce/N ew Bshk ekov ikoh
ehsk ikt/rk.
d[gosh ;oNhfce/N$Bshk ekov b?D bJh G/ih rJh ch; fe;/ th jkbs ftu tkg; Bjh ehsh ikt/rh .
fJe tko d[gosh ;oNhfce/N$Bshk ekov ikoh jD T[gozs i/eo eJh gqhfynkoEh d[pkok d[gosh ;oNhfce/N ew
Bshk ekov b?D dh wzr eodk j? sK T[; ;{os ftu T[j n?ri?efNt w?fi;Nq/N sA s;dhe jfJnk jbchnk fpnkB
th g/ eo/rk fe T[; tZbA gqkgs ehs/ d[gosh ;oNhfce/N ew Bshk ekov dh d[otosA Bjh ehsh ikt/rh.
i/eo eJh gqhfynkoEh$fpB?eko so[ZNhnK tkb/ e/;K ftZu dcso tZbA ikoh gZso$nzfsw :kd gZso d/ ikoh jD sA
1 wjhB/ d/ nzdo$sZe eJh ekotkJh BjhA eodk sK T[; d/ d[gosh ckow Bz{ dkyb dcso eo fdZsk ikt/rk ns/ w[V
sA BtK d[gosh ckow BthA ch; gqkgs jD T[gozs jh ekotkJh ehsh ikt/rh.

;oNhfce/N ftZu ;X bJh bVhAd/ d;skt/ ns/ jdkfJsK L1a

2a

3a

4a

gzithA (i/eo pov sA ehsh jt/) nZmthA, d;thA ns/ pkoQthA ebk; d/ ;oNhfce/N; dhnK ;woZE nfXekoh
sA s;dhe ehshnK cN ekghnK BZEh ehshnK ikD ns/ fi; ebk; ftZu ;X wzrh rJh jt/ T[; ebk; dk
dk n;b ;oNhfce/N BZEh ehsk ikt/.
;pzXs ebk; fi; ftZu ;X wzrh rJh jt/ d/ dkybk ykfoi ofi;No dh ekgh ;e{b ns/ ;pzXs fibQk w?B/
io, y/soh dcso, gzikp ;e{b f;Zfynk pov sA s;dhe eotk e/ Bkb brkJh ikt/. i/eo T[; (dkybk
ykfoi ofia) ftZu eJh efNzr j? sK fJ;B{z ;oekoh$J/fvv ;e{b d/ gqhfynkoEh ;pzXs fibQk f;Zfynk
nc;o (DEO) sA ns/ n?chbhJ/AfNv$n?;;hJ/fNv ;e{b Bkb ;pzXs gqhfynkoEh gzikp ;e{b f;Zfynk pov d/
fJzukoi n?chbhJ/B$n?;;hJ/B iK ;pzXs fibQk w?B/io sA gqsh j;skyo (Counter Sign) eotk e/
BZEh eoB.
i/eo d;thA ns/ pkoQthA ftZu nzro/ih d/ pdk ftZu so[ZNh j? sK nkXko ekov$Bkysh ekov$gk;goN$
vokfJftzr bkJh;?A; dh s;dhe[dk cN ekgh Bkb brkJh ikt/. fiZE/ dcso io{os ;wMdk j?, bV
nB[;ko dkybk ykoi ofi;No th wzrtkfJnk ik ;edk j?.
;e{b d/ Bkw dh ;X bJh ;e{b w[Zyh sA ;e{b d/ b?No g?v s/ fi; ;?B ;w/A ;pzXs fpB?eko T[; ;e{b dk
gqhfynkoEh ;h, T[; ;w/A ftZu i ;e{b dk Bkw ;h, fbytke/ Bkb BZEh ehsk ikt/.

BN L- ;oNhfce/N e/tb n;b gqhfynkoEh B{z jh d;sh fdZsk ikt/rk iK fdZs/ gs/ s/ ofia vke okjhA
G/i fdZsk ikt/rk. ofi;Nov vke okjhA G/i/ d[gosh ;oNhfce/N dh gj[zu dh fzw/tkoh pov dcso dh
BjhA jt/rh.

u?Ze fb;N
d[ gosh ckow GoB ns/ gq kgs
1a
2a
3a
4a
5a
6a

eoB ;wQ /A j/m fby/ fbyhnK jdkfJsK nB[;ko ckow u?Ze eo fbnk ikt/ L-

ckow fpB?eko tZbA y[d Gfonk ikt/.

ckow ftZu ;ko/ t/ot/ fpBQK fe;/ efNzr sA Go/ jJ/ jB.
ckow ftZu ch; dk t/otk fit/A o;hd Bzpo, fwsh ns/ oew nkfd Gfonk j? ns/ n;b o;hd ckow Bkb
BZEh j? (fpBQK ch; iK xZN ch; tkbk ckow gqkgs BjhA ehsk ikt/rk).
ckow ns/ cN dBA fJZeA jh ;woZE nfXekoh sA s;dhe jB.
gZso ftjko bJh gsk ckow ftZu fdZshnK dtK EKtk s/ Gfonk j?.
ckow ftZu gqhfynkoEh B/ gzikph ns/ nzro/h ftZu g{o/ j;skyo ehs/ jJ/ jB.

i/ eo ;oNhfce/ N ftZu ; X eotkT[D h j? sK j/m fbyhnK jdkfJsK nB[; ko d;skt/ u? Ze eo bJ/ ikDL1a
2a
3a

fi; ebk; d/ ;oNhfce/N ftZu ;X eotkT[Dh j?, dk n;b ;oNhfce/N BZEh j?.
fizBQK ebk;K d/ ;oNhfce/NK d/ nkXko s/ ;X eotkT[Dh j? (nZmthA, d;thA ns/ pkothA) d/ ;oNhfce/N dhnK
;woZE nfXekoh sA s;dhe [dk ekghnK BZEh jB.
dkybk ykoi ofi;No dh s;dhe [dk ekgh. (jdkfJsK w[skpe)

4a

nkgDk ns/ ;X nB[;ko jo bVhd/A Bkys ;pzXh ;p{s BZEh jB.

BN L i/eo T[es jdkfJsK nB[;ko ckow ezgbhN BjhA j? sK ckow gqkgs BjhA ehsk ikt/rk.