1. Name of Candidate:

UDISE NO

Aadhaar No.

PEN NO.

Apaar ID

2. Date of Birth :
(ddMMYYYY)

Student Photograph (Max 50 Kb)

3. Name of Institution
(in which the candidate is studying/ Last Attended)

Class XI Detail Entry

	4.	Acaddemic Achievement	Year	English (%)	Maths (%)	Science (%)	Total Marks Obtain	Pass % or Grade
		Class-IX
		Class X (Pre-Board)
		Class-X

	5.	Subject for Science Stream.
		(A) Cpmpulsory Subject			(B) Optional Subject (Tick (√ )Any Two)
			English			Maths
			Physics			Biology
			Chemistry			Computer
						Hindi

	6.	Achievement in Extra/Co-Curricular Activities/Sports/Games :-
		(1)				(2)
		(3)				(4)

7. Father's Name :

Aadhaar No

Father's Qualification :

Signature of the candidate (Max 50 Kb)

Father's Occupation : Service/Business/Others
(if in Govt./Pvt Service Specify Design & Name of Dept.)

Mother's Name :

Aadhaar No

Mother's Qualification :

Photograph of parents/guardians (Max 50 kb)

Mother's Occupation : Service/Business/Others
(if in Govt./Pvt Service Specify Design & Name of Dept.)

Gender :

Name of parents/guardians

8. Address :

City :

State :