Duplicate Admit Card

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No 045525

Eardhaman Reglonat Office :


Price Rs. 15.00

To
W. B. Council'of H. S. Education
The Deputy Secretary (KRO/MRO/BRO/NBRO)
Nazrul Bhavan
West Bengal Council of Higher Secondary Education
Behind LIC Office,
Central Offtce :
5, lchlabad (Jalkal Math)
West Bengal Council of H. S. Education
P.O. : Sripally, Pin - 713103
Vidyasagar Bhavan
Dist. : Bardhaman
9/2, Block DJ, Sector-ll
Ph. : 0!42-2il47 20 r2il 1 427
Salt Lake, Kolkata-700 091
edlnlpur Regional Office :
Ph. : 033-2337-4984 to 87
W. B. Council of H. S. Educafon
Kolkata Regional Oflice :
Sahid Matangini Bhavan
W B. Council of H. S. Education
Bidhannagar East, 72, Station Road
Bikash Bhavan
P.O. : Medinipur, Dist. : Paschim Medinipur
North Block (2nd Floor)
Pin-721'101, Ph. : 03222-276-318
Salt Lake, Kolkata - 700 09'l
Ph. : 033-2334-3'193
Police Diary No. ...,....
North Bengal Regional Office :
W B. Council of H.S. Education Date... ... ... . .. ... ... ... ... .

Rahul Sankrityayan Bhavan (ln case of lost or stolen)


PO. : North Bengal University
Dist. : Darjeeling, Pin-734013 Signature of the O. Q. of PS.
Ph. : 0353-2582-097
Subject: APPLICATION FOR DUPLICATE ADMIT CARD
Sir,
I beg to opply for issuing a Duplicate Admit Card in my favour for the Higher Secondary Examination /
Higher Secondary (External) Examination..............................(ln case of Stolen / Lost. Police Diary is to be
enclosed and in case of damaged. the damaoed Admit Card is to be attached).

(for Council's office only) (ln Block Letters)

2. Father's/Mother'Y
Guardian's Name .

3. FullAddress

4. Name, Address and


code of the lnstitution

5. REGISTRATION NO.
WTH YEAR
6. ROLL& NO.
WITH YEAR :

7. Name the subjects offered :

by hirn/her in the said


Examination
Rs.2n^,
8. The fees of Rs. @ e.+aegEF.t), Rs. ftlJrgratfeclshall be paid
for the DuplicateAdmit card. Such fees shall be deposited by cashibank
Two copies of Pass-port size draft drawn in favour of 'W. B. Council of H. S. Education'.
Photographs of that applicant
I like to take delivery of my document personally / by post / through
attested by the Head of the
lnstitution. (Strike out whichever is not applicable)
lnstitution are to be enclosed
Yours faithfully,
in case of Higher Secondary
(Continuing) & Spl. Candidate
and H. S. (Exemal) Candidates
from 1983 to 1989.

9ate..................... Full Signature of the Candidate

I certif, that the above statement made by the applicant is true to the best of my knowledge and belief.

Date. Signaturc of the Head ot the lnstitution with Offrca Seal


Code number of the lnstitution

PT.O.
N.B. : (1) Application Form filled in wrongly will be rejected without any reference to the applicant.

(2) Document applied for remaining unclaimed beyond six months from the date of receipt will be
desboyed. Fees submitted for the purpose shall not be refunded even in the cases of rejeded
forms.

(3) ln case of personal delivery, letter of authority (specimen below) from the lnstitution should be
produced at the time of delivery.

(4) ln case of postal delivery, cunent postal charge (Registratio4) shall be paid separately in the
prescribed manner mentioned at SL. No. 8 of the application.

SPECIMEN OF LETTER OF AUTHORITY

To
The Deputy Secretary (KRO/MROiBRO/NBRO)
W. B. Council of H. S. Education

Sub : Delivery of Duplicate Admit Card

Dear Sir,

I do hereby authorise Shri/Smt.

to receive the duplicate Admit Card of Shri/Smt.

bearing Roll No at the Higher Secondary Examination

in General / Vocational Stream / H. S. External Examination.

The Signature of Shri/Smt.

is attested below by me.

Date Yours hithtully,

Signature of Shri/Smt.
ATTESTED (Signature of the Head of lhe lnstruction
with Office seal)

TTIIIT
Code number of the lnstitution

(Signature of the Head oi the lnstitution


with Otrce Seal)

Delivery Of Duplicate Admit Card


Urgent: Normally within 10 clear working days.
Ordinary . Normally within 30 clear working days.

Order No. O.S./PTC'/3.04/3212015 dated 11.09.2015/1,00,000 Copies.

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