A       w n Nar G 9 A .
oa167APP}ENDIX 16
CUDDAPAH DIST.
                               3   eoscssiw, 99%S 2dasäsioo RULE 99,CHAPTER III
             s o a t FORM OFTRANSFER CERTIFICATE
  1. Bbbsgsi aoug 3 9 3                                                         Z.P. HIGH SCHNAL
     Transfer Cortifticate No. AG o5-ds
                                                                                    UPPALUR 516 G80
                                                                                 Muddanur (M)   Kadapa Dt
       Name of the School (Place and Distriet)
       Highest Class in the School
                                                                      Fomporary Recognition accorded in Ro
                                                                      No: 6415/e3/2001 Dt : 23-11-2001 of
       If Non-Government, Class upto which Recognized
       No. and Dale of Recognition Orders
                                                                      ho B.J.D. Cuddapaha
  2.            /     Doo
       Name of the Pupil
                                                           PALLA S RiyinyA
  4.
       Name of the Parent or-Guardian
                oS, Soeso5 & soSSs»
                                                            SP Napyhomam
           Nationality. Religion & Cast                               ndian= H n d                   hatalta
           Whether the candidate belongs to Scheduled Caste
       or Scheduled Tribes or Vimuktha Jathis or Other
       socially and cducationally backward classes
       specified in the Andhra Pradesh Educational Rules
       or is he a converted from the Scheduled Caste or
       the Scheduled Tribe ?If so the particulars thereof.
                                                                      BaCkd                          Bc-624
  6.
                                                                      9-&1982
       Date of Birth (in words) as entered in the
       Admission Register                                                     ha y                e)         O
  7.   ) ore a60               3yY DsSS
             Class in which the pupil was reading at the
             time of leaving (in words)
       )        1) GSD rs
                     First Language
                2) aroos P
                     Second Language
                                                                          ,
       3) 1)        S°) S°E»y (¢En Da                      ?   )
               Coùrse offered (i.e. whether Academic or
 8. 1) Srsrá
                Bifurcated and the subject offered under the
               bifurcated course)
                              2)    á
                                                                         Aca
       3) 5 5 »               ss°) rá
       Mother Tongue          Medium of Instruction       Optional
                          -
                                                      -
       Date of Adaiien or Promotion to the Class
                                                               (The
       year to be entered in words)                                            June 994
                                                                       Mskeen intyoy)
                                                         -2
10. 0 r o              °0>8                    os
       Class and year in which the puril was first
       admitted in the school                                   21 o6 -1993
                                                                                                    vomdtm
       Whether qualified for promotion to a higher class.
12.             /osg        oToas          39oSSes
       Whether the pupil has paid all the fees due to the
       School
13. ) a / s a s DSw                    o8ay årod
       Whether the pupil was in receipt of any
       Scholarship.    (Nature of the Scholarship to be
       specified)
14.
       ossSs6 eg/sg 36 sôg
       OAs ? Jess3».
       Whether the pupil has undergone medical
       inspection during the year first or repeat (to be
       specified)                                                            No -
15.             /as 5), KoQo                 D       e
        )
        ii)
16.             3g          P6TO` S o r Sa8
                                                                 22-04-1995
        Date on which the pupil actually left the school.
17.             /2rs9 soOI sO/s s/öo
        Date on which application for Transfer Certificate
        was made on behalf of the pupil by kis/her Parent
                                                                       15-A0-20055
       orGeerdien.
18. »ds s83s Sa
        Date of the Transfer Certificate
                                                                        15-10-20nS
19. 5
    Conduct
20. a / 9                    SEKO DdOs533
        Attendance in the class of leaving
21. T e $IB33 BSKoe 3 v » $ops
        Total number of working days
22. S g g v $oaSKo
        Signature of the Head of the School.
                                                                      HEAD MA$TER s J
                                                                  Z.P. HIGH SCHOCOL
                                                                       UPPALUR S16 80
                                                                  Muddanur (M) Kodapa Dt.
Note            In case the pupil is leaving the State of Andhra Pradesh this Certificate will not be valid without the
                counter Signature of Inspecting Officer concerned.
                                   (As per G.0.Ms.No.40 Edu (Ser-V) date: 7-5-2002.)