Sadiq Progressive School

Bahawalpur

Admission Form

Applicant's Name:

B.Form:

Ayesha Shahbaz

3120274443450

Gender:

Female

Date of Birth:

Father's Name:

Mobile:

Mother's Name:

Shahbaz Rafiq

03053035555

Asia Siraj

CNIC:

3120284504591

Profession:

Job

CNIC:

3120250008534

Mobile:

03053035555

Profession:

Housewife

Permanent Address of Father/Mother:

Mohalla Dera Izzat, Bahawalpur

District:

Bahawalpur

Province:

Punjab

Tel:

03053035555

Mobile:

03053035555

Email:

Address for Correspondence:

Mohalla Dera Izzat, Bahawalpur

District:

Bahawalpur

Religion:

Class last attended:

Islam

Nationality:

New Admission

Province:

Punjab

Pakistani

Medium of Instruction:

County of stay:

Pakistan

New Admission

School last attended:

Nil

Board/University:

Identification Mark:

Nil

Admission desired in class:

0P

with effect from:

15-09-2020

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

Sameed-ul-Hassan

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

i)

Abdul Malik

Relation with student:

Uncle

Tel:

03015052595

Mobile:

03015052595

ii)

Hafiz Muhammad Najeeb

Relation with student:

Uncle

Tel:

03008161709

Mobile:

03008161709

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:

Ayesha Shahbaz

Gender:

Son/Daughter of:

Shahbaz Rafiq

Phone:

Address:

Mohalla Dera Izzat, Bahawalpur

Name of person:

(Who may be contacted in case of emergency)

Phone:

03016987948

Admission for Class

0P

Date of Birth:

Blood Group:

A+ve

Allergies to Drug (              )

Drug

Allergies to Food (               )

Food

Physical disabilities(                )

phy

Respiratory Problems / Asthma (                )

Asth

No

Hamza Almas Khan

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

Female

Father's CNIC

Mother's CNIC

Father's Police Report

B Form

Vaccination Card

Academic Report

Result Card

Deposit Slip

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