Leelawati Public School

Refrence No:- 3ffaf30fc5e36db3dbf8

Student Name*

Father Name*

Mother Name*

Mobile Number*

Email

Select Class --Select Class--

Permanent Address*

Alternate Address*

Select SEX Male Female

State*

District*

Zip Code

Select Date Of Birth*

Date Of Birth in Words*

Select Category Gen. SC ST OBC

OCCUPATION*

NAME OF THE SCHOOL LAST ATTENDED

ADDRESS OF THE SCHOOL LAST ATTENDED

RESULT OF LAST EXAMINATION PASSED FAILED

PERCENTAGE OF LAST EXAMINATION

Select Class --Select Class--