Education

a. Application For Photocopy.....................

Application for the photocopy.

1. Name of the candidate
and Complete residential
address

Pincode:

2. Examination
registration
number

Year of examination
and month

Year	month

3. Name and address of the
   High school/Composite
   junior college where the
   candidate has studied

4. No. of the Examination
center

Code No. of the School

5. Subject for which the candidate wants photocopy

Subject	Subject Code	Medium
Mathematics	81

6. Fee paid Amount Rs.__________________in words___________________________

Bank DD No.__________Date______________Name of the bank________________

It is certified that the facts given above are true and factual.

Date: Signature of the candidate/Parent