Station.: Gctisscty
Station.: Gctisscty
School Regis traticn No. C[3, 26365 26465,521 Dt. 21-1- 1968
No, change in any cntry n this Certifcate shall be made exopt hy the authority
issuing it and ofringcment of (his requirement is liable to iivolve the impositioh
of a pecnalty sHch as f tustication,
(2004 -2005 )
Serial No, B 4548
Shri S. M. K. R. Vashi High School, Maroli Station.
S. S. C. Index Tal, Jalalpore,
Dist. Navsari. H, S. C. Index
No. : 78.008 LEAVING CERTIFICATE No. :
23-010
Register No. of tho pupil
13 489
1. Name of the pupil in full Mistay Nideshkumu
Hatishbhai
2. Religion Himbe Kynbhuk and Sch. caste or sch. Tribe
3 Place of Birth fmke4 Hosp,tjaluka Gcuncevi Dist.
Velsdd
4, Date of Birth according -
to Christian era (
Q1-o7 1185
in figures)
FiAst huly.
and in words
Nineteen hund ed Eighty - Five
5. Last School attendedPirnaty
Schol Simalgu)
Tal: Nuvscti 6. Date of Admission 12-6-97
7. Progress GctissctY 3. Conduct
9. Date of leaving the School
10.
31-5-
Standard in which Studying and since when
01
X-D(th)
11. Reasons of leaving the School
Sice June 2000
12.
Set ptA 5.5.CExUm
Attendance
Remarks
Arzil 2o91
13. Failed cand etuined in stc x-D
CTenth)
Certificd that the above nformatiou is
in accordance with the Schogl
Register
Maroli Station.
Date 5
-3-25
lclo
. Scheel
Cortificato fee it any :- Rs. Shri M.!r 1h
Arrear of fees, if any :- Rs. MAROL! STATION, Dist. Nvsarl.
Fees for, the month of