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General Reg. No.

LEAVING CERTIFICATE

Certificate No.

Sections	PRIMARY SECTION SECONDARY SECTION
Student Saral ID.
Unique ID (Aadhar Card No)
Name of student in Full (Name-Father's name-Surname)
Mother's Name
Mother Tongue
Nationality
Religion,Caste & Sub-caste
Place Of Birth (village,city,taluka,zilla,State,Country)
Date of Birth (in Figures)
Date of Birth (in words)
last school attended & Std.
Date of admission & Std.
Progress
Conduct
Date of leaving school
Standard in which studying & since when
Reason of Leaving school
Remarks

Certified that the above information is in accordance with the school General Register.

Certificate Issuing Date :

Clerk:

Principal:

Note : Any changes in this leaving certificate will be liable for punishment.