BOARD OF INTERMEDIATE AND SECONDARY EDUCATION, GUJRANWALA
ADMISSION /REVENUE FORM (Private Candidate) for SSC Annual Examination , 2017
Roll No: _______________
(For office use only)
GENERAL GROUP
Form No: 161043 (10th: Full Appear)
161043
Prev Roll No: 288581 ( A, 2016 ) Bay Form No: 34101-8320300-5
Name: MUHAMMAD USMAN Father CNIC: 34101-1123301-3
Father's Name: ZIA-ULLAH Mobile No: 0334-4186455
Date Of Birth: 06-11-1998 Board Name: BISE, GUJRANWALA
Registration No: 2-3-221702-15 Religion: MUSLIM
Speciality: NONE
MALE
Address: SAEED AHMED, ST# 10,JAHANGIR COLONY, KHOKKERKI SIALKOT ROAD GUJRANWALA.
Proposed Exam Area: 44 - SATELLITE TOWN (GUJRANWALA)
Part I Subjects Part II Subjects Paste Recent
1. URDU Photograph & Must Be
2. ENGLISH Cross Attested by the
3. ISLAMIYAT (COMPULSORY) Head/Deputy Head of
Candidate's
4. PAKISTAN STUDIES Thumb Institution
Impression
5. General Math
6. GENERAL SCIENCE
7. EDUCATION
8. ISLAMIC STUDIES
Affidavit:- I have read this form. The data/information on this form and in online system is same as last entered/modified/provided by me and it's correctness
is only my responsibility.I understand that only the information/data provided in the online system along with the photograph and some other handwritten
details on this form will be used for further processing. I accept all the terms and conditions in this regard.
Candidate's Signature in Urdu______________________ Signature
Headmaster/Headmistress/Principal
Candidate's Signature in English____________________ Head Of Institution Name
School/College Code Head of Institution Stamp
Due Date: 14-12-2016
CNIC
Printing Date: 13-Dec-2016 09:40 AM CMD Account No. 00427900072103 Bank Challan No. 161043
Admission Fee 650/- Late Fee 0/- Processing + Form Fee 295 /- Certificate Fee 550/- Registration Fee 0/-
Total Amount Rs. 1495 /- Amount in Words: One Thousand Four Hundred And Ninety Five Only.
Manager/Cashier:___________________________
BOARD OF INTERMEDIATE AND SECONDARY EDUCATION GUJRANWALA (SSC Annual Examination ,2017 )
Bank Copy: (To be retained with HBL)
Printing Date: 13-Dec-2016 09:40 AM
Due Date: 14-12-2016
Form No: 161043 CMD Account No. 00427900072103 Bank Challan No. 161043
Name: MUHAMMAD USMAN Father's Name: ZIA-ULLAH
Total Amount Rs.1495/- Amount in Words: One Thousand Four Hundred And Ninety Five Only.
Manager/Cashier:___________________________
BOARD OF INTERMEDIATE AND SECONDARY EDUCATION GUJRANWALA (SSC Annual Examination ,2017 )
Board Copy: (Along with Scroll)
Due Date: 14-12-2016 Printing Date: 13-Dec-2016 09:40 AM
Form No: 161043 CMD Account No. 00427900072103 Bank Challan No. 161043
Name: MUHAMMAD USMAN Father's Name: ZIA-ULLAH
Admission Fee 650/- Late Fee 0/- Processing + Form Fee 295/- Certificate Fee 550/- Registration Fee 0/-
Total Amount Rs. 1495/- Amount in Words: One Thousand Four Hundred And Ninety Five Only.
Manager/Cashier:___________________________
BOARD OF INTERMEDIATE AND SECONDARY EDUCATION GUJRANWALA (SSC Annual Examination ,2017 )
Candidate Copy Printing Date: 13-Dec-2016 09:40 AM
Due Date: 14-12-2016
CMD Account No. 00427900072103
Form No: 161043 Bank Challan No. 161043
Name: MUHAMMAD USMAN
Father's Name: ZIA-ULLAH
Total Amount Rs. 1495/-
Proposed Exam Area: 44 - SATELLITE TOWN (GUJRANWALA)
Manager/Cashier:___________________________