3120255941617

Sadiq Progressive School

Bahawalpur

Admission Form

Applicant's Name:

B.Form:

Muhammad Ayyan

3120255941617

Gender:

Male

Date of Birth:

Father's Name:

Mobile:

Mother's Name:

5 October 2010, 12:00:00 am

Muhammad Amir

03039875225

Nazish Shoukat

CNIC:

3120269174615

Profession:

TNB Power Plant

CNIC:

3120273279606

Mobile:

03039875225

Profession:

House Wife

Permanent Address of Father/Mother:

Shahi Bazar, Bhobi Wali Galli, Mohallah Kucha Gul Hassan, Bahawalpur

District:

Bahawalpur

Province:

Punjab

Tel:

0622201749

Mobile:

03039875225

Email:

Address for Correspondence:

Shahi Bazar, Bhobi Wali Galli, Mohallah Kucha Gul Hassan, Bahawalpur

District:

Bahawalpur

Religion:

Class last attended:

Islam

Nationality:

5th

Province:

Punjab

Pakistani

Medium of Instruction:

County of stay:

Pakistan

English Medium

School last attended:

Apwa Public School farid gate Branch Bahawalpur

Board/University:

PEC Punjab

Identification Mark:

Nil

Admission desired in class:

5P

with effect from:

6th

Roll no. Name & Class of brother/Sister(s) at present studying  at Sadiq Public School:

Nil

Name and address of two persons (who may be contacted in an emergency):

i)

Saleem Shahi Bazar, Bhobi Wali Galli, Mohallah Kucha Gul Hassan, Bahawalpur

Relation with student:

Uncle

Tel:

0622201749

Mobile:

03034504168

ii)

Ali Shahi Bazar, Bhobi Wali Galli, Mohallah Kucha Gul Hassan, Bahawalpur

Relation with student:

Uncle

Tel:

0622201749

Mobile:

03077318035

2. School reserves the right to accept or reject any admission or withdraw / rusticate after admission which shall not be challenged in any Court of Law and Forum.

3. I promise:

i.  to pay the fees in advance timely, as laid down in the School rules, and to give one month's notice of withdraw or to pay one month's fee in lieu thereof.

ii. to pay the scale of fees fixed from time to time by the Competent Authority / Board of Governors which shall not be challenged in any Court of Law and Forum..

I understand that all students are required to participate in the full curriculum, i.e. Discipline, Academics, Sports, Non-sport activities, and Community Service.

Govt. Servant (father) posted at Bahawalpur city:

Govt Servant

                               

Father

                               

Mother

(For Office Use Only)

Test / Interview on:

Admitted to Class:

Amount Paid Rs.:

Roll Number:

Controller

Hd. M.

Boarder / Day Pupil:

SDFRs:

SDFRs

Cashier

Registrar

House:

Dated:

Vide Receipt No:

Accounts Officer

PRINCIPAL

Sadiq Public School

Bahawalpur

Student Medical Information Form

PART I TO BE FILLED IN BY THE PARENTS

Roll Number:

Form #:

Name of Applicant:

Muhammad Ayyan

Gender:

Son/Daughter of:

Muhammad Amir

Phone:

Address:

Shahi Bazar, Bhobi Wali Galli, Mohallah Kucha Gul Hassan, Bahawalpur

Name of person:

(Who may be contacted in case of emergency)

Phone:

03039875225

Admission for Class

5P

Date of Birth:

5 October 2010, 12:00:00 am

Blood Group:

B +ve

Allergies to Drug (              )

Drug

Allergies to Food (               )

Food

Physical disabilities(                )

phy

Respiratory Problems / Asthma (                )

Asth

No

Muhammad Amir

Vision / Hearing Problems (                  )

Vision

Dates of Last Immunization: EPI                                                   Hepatitus A                                                    Typhoid                                                  

Mumps                                                   Chicken Pox                                                  Flu                                                  

Is the Applicant Presently Taking any Medications? (                       )

Special Medical Conditions/ other Pertinent Information including SURGERIES,HOSPITALIZATION, JAUNDICE, BLOOD TRANSFUSION, EPILEPSY, DIABETES MELLITUS, HYPERTENSION, etc (add additional page if necessary)

____________

Date

____________

Father

____________

Mother

PART II TO BE FILLED IN BY THE SCHOOL MEDICAL OFFICER

Physical Examination:

Height                                    (cm)  Weight                                    (Kg)  Blood Pressure                                   mm/hg  Pulse                                   /min

Laboratory Investigations:

HBsAg: -ve     /+ve

HCV: -ve     /+ve

X-Ray Chest: Normal               /  Abnormal

Examination Date

Senior Medical Officer

med

Male

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Father's CNIC

Mother's CNIC

Father's Police Report

B Form

Vaccination Card

Academic Report

Result Card

Deposit Slip