Issue of Duplicate Mark Sheet Ahsec

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Department: SECONDARY EDUCATION

ISSUE OF DUPLICATE MARK SHEET AHSEC


()
(*Marked Fields are mandatory)
(*চিহ্নযু ক্ত তথযব োৰ োধযতোমূ লক)

Applicant’s Details (আব দনকোৰীৰ চ ৱৰণ)

*Applicant’s Name (আব দনকোৰীৰ নোম) Mr Mrs Miss

………………………………………..

*Mobile Number (ম োইল নম্বৰ ) ………………………………………..

Father's Name in full (চ঩তৃৰ নোম( ………………………………………..

Mother's Name in full (মোতৃৰ নোম( ………………………………………..

Mail Id ( ) ………………………………………..

Pan Number ( ) ………………………………………..

Aadhar card Number ( ) ………………………………………..

Address Details ( )

Address in Full ( ) ………………………………………..

*State (ৰোজ্য) ………………………………………..

*District(চজ্লো) ………………………………………..

*Sub-Division (মহকুমো) ………………………………………..

*Circle Office(ৰোজ্হ িক্র) ………………………………………..

*Post Office(ডোকঘৰ) ………………………………………..

*Police Station(থোনো) ………………………………………..

*Village/Town(গোওঁ/নগৰ) ………………………………………..

*Pin Code(চ঩ন নং) ……………………………………….. (e.g 78xxxx)

Signature of the applicant


(আব দনকোৰীৰ িোক্ষৰ)

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Department: SECONDARY EDUCATION

ISSUE OF DUPLICATE PASS CERTIFICATE - AHSEC


()
(*Marked Fields are mandatory)
(*চিহ্নযু ক্ত তথযব োৰ োধযতোমূ লক)
Candidate's Information ( )

Name of the School/College ( ) ………………………………………..


Name of Principal () ………………………………………..
Name of Student () ………………………………………..
Name of the Examination ( ) ………………………………………..
Name of College/School from where appeared
in the above Examination ( ) ………………………………………..
Candidate is Regular Private Compartmental
Roll no( ) ………………………………………..
Year of Passing( ) ………………………………………..
Registration certificate no () ………………………………………..
Total marks obtained ( ) ………………………………………..
Result ( ) ………………………………………..

Other details ( ) ………………………………………..

Purpose of the document ( ) ………………………………………..


What happened to the original document()………………………………………..
Challan no ( ) ………………………………………..
Bank draft no ( ) ………………………………………..

Supporting Documents (সংলগ্ন নচথ)

1. Recommendation letter from the Head of the Institute along with copy of FIR in case of
loss/theft
2. In case of partial damage of the original mark-sheet, the damaged mark sheet should be
attached with the application
3. Photocopy of Admit Card duly attested
4. A self-addressed stamped ( Registered / General as the case may be) envelope is to be
enclosed along with the application form
5. Any other document.

Signature of the applicant


(আব দনকোৰীৰ িোক্ষৰ)

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