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
Place: Seal and Signature
Date: (D.E.O / Principal)