Counselling and General Information Report

Student 1 Details Students 2 details

Sr.No. 172/10 Sr.No. 14/18
Admission no. Admission no. 1422/18

Aadhar no. 992067442413 Aadhar no. 258973709957

Name of student Hazra Bano Name of student Harsh Soni
Class 10 Class ix
Section A Section B
Session 2019-20 Session 2019-20
Date of birth 03/03/2001 Date of birth 7/7/2004
Gender Female Gender Male
Blood group B+ Blood group A
Illness /General Illness /General G.H
health health
Birth place Bhanauli Birth place Bhanauli musafirkhana Amethi

Mother’s name Shahnaz Fatima Mother’s name Mrs. Anita soni

Year of birth 1960 Year of birth 1984
Weight 48 kg Weight 51kg
Height 155 cm Height 5.ft
Blood group B+ Blood group A
Illness/General Dybatic Illness/General G.H
health health
Aadhar no. 342369179631 Aadhar no. 304624240433
Monthly income - Monthly income -
/if any /if any

Fathers’ name Awn Mohhamad Fathers’ name Mr Kedarnath soni

Year of birth 1965 Year of birth 1980
Weight 78 kg Weight 55 kg
Height 180 cm Height 5.inch
Blood group B+ Blood group A
Illness/General Illness/General GH
health health
Aadhar no. 264967818408 Aadhar no. 384144069541
Monthly income 50000 Monthly income 5000
/if any /if any
Occupation Business Occupation Student

Brother/sister 1 Brother/sister 1
Name Ahmad Raza Name Harshit Soni
Year of birth 2003 Year of birth 2007
Weight 60 kg Weight 30 kg.
Height 170cm Height 4 ft
Blood group B+ Blood group A
Illness/General Illness/General GH
health health
Aadhar no. 934909583627 Aadhar no. -S
Monthly income - Monthly income 5000
/if any /if any
Occupation - Occupation

Brother/sister 2 Brother/sister 2
Name Monis Raza Rizvi Name
Year of birth 1989 Year of birth
Weight 72 kg Weight
Height 170 cm Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. 243966443237 Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Ghulam Hussain Name
Year of birth 2005 Year of birth
Weight 60 kg Weight
Height 160 cm Height
Blood group B+ Blood group
Illness/General Illness/General
health health
Aadhar no. 778058736920 Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly 50000 Family’s monthly 5,000

income income
Full address Village & Post Bhanauli Full address Jogibiran,Paliya Purab,Musafirkhana
Musafirkhana (Amethi)
Contact details 9935372816 Contact details 9984897348
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( √ ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion. We take counselling classes of Discussion:- He has no problem in studies and
this student and she told us that very happy with his homes
her mathematics subject is not so atmosphere also.
good and she wants to become a
doctor but we advised her to give
some concentration to math also.
 Counselling and General Information Report
Student 1 Details Students 2 details
Sr.No. 005/10 Sr.No. 740/13
Admission no. Admission no. 00039/13
Aadhar no. 396372928580 Aadhar no. 715549554382
Name of student Huda Fatima Name of student Iqra bano
Class X Class Ix
Section A Section B
Session 2018-19 Session 2019-20
Date of birth 25.12.2005 Date of birth 28/3/2005
Gender Female Gender Female
Blood group O+ Blood group O+
Illness /General G.H Illness /General GH
health health
Birth place Birth place BhanauI Msafirkhana

Mother’s name Mrs .Sahida Bano Mother’s name Mrs Nasreem jhan
Year of birth 16.12.1981 Year of birth 1980
Weight 60 Weight 75kg
Height 1.56cm Height 163cm
Blood group B+ Blood group B+
Illness/General G.H Illness/General SINUS
health health
Aadhar no. 620633010923 Aadhar no. 526396729019
Monthly income 10,000 Monthly income -
/if any /if any

Fathers’ name Mr.Tahreer Haider Fathers’ name m

Year of birth 18.4.1968 Year of birth
Weight 80kg Weight
Height 1.67cm Height
Blood group O+ Blood group
Illness/General G.H Illness/General
health health
Aadhar no. 363501509160 Aadhar no.
Monthly income 10,000 Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly 10,000 Family’s monthly

income income
Full address Bhanauli, Musafirkhana (Amethi) Full address
Contact details 9161284628 Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- We take Counseling classes of Discussion:-
Huda Fatima she told that she
feels hesitation in asking
questions to the teacher we talk
and advise her to never feels
hesitation .
 Counselling and General Information Report
Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Fema
Fathers’ name Fathers’ name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation
Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-
 Counselling and General Information Report
Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation
Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-
 Counselling and General Information Report
Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-
 Counselling and General Information Report
Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-
 Counselling and General Information Report
Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-
 Counselling and General Information Report
Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-
 Counselling and General Information Report
Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-
 Counselling and General Information Report
Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.
Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )
Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.
Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )
Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Fathers’ name Fathers’ name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Fathers’ name Fathers’ name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation
Family’s monthly Family’s monthly
income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation
Family’s monthly Family’s monthly
income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place

Mother’s name Mother’s name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-

Counselling and General Information Report

Student 1 Details Students 2 details
Sr.No. Sr.No.
Admission no. Admission no.
Aadhar no. Aadhar no.
Name of student Name of student
Class Class
Section Section
Session Session
Date of birth Date of birth
Gender Gender
Blood group Blood group
Illness /General Illness /General
health health
Birth place Birth place
Mother’s name Mother’s name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any

Fathers’ name Fathers’ name

Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 1 Brother/sister 1
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 2 Brother/sister 2
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Brother/sister 3 Brother/sister 3
Name Name
Year of birth Year of birth
Weight Weight
Height Height
Blood group Blood group
Illness/General Illness/General
health health
Aadhar no. Aadhar no.
Monthly income Monthly income
/if any /if any
Occupation Occupation

Family’s monthly Family’s monthly

income income
Full address Full address
Contact details Contact details
/ mobile no. / mobile no.

Nature of family:- a) Single or Joint ( ) b) Orthodox or Libral ( ) c) Rural or Urban ( )

Discussion:- Discussion:-