Certificate by the Candidate from Rural Area School
No. Dated:
Certified that Mr. / Ms. ______________________ son / daughter of Sh. ______________________ ______________________________ and Smt. ________________________________ resident of _________________________________________ has passed the matriculation and +2 examination from Rural School(s) that does not fall in the area of the Municipal Corporation / Municipal Committee / Small Town / Notified Area.
| Name of School | Date of joining | Date of leaving | |
| 1. | |||
| 2. | |||
| 3. | |||
| 4. |
Place: Seal and Signature
Date: (D.E.O / Principal)