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Shri Markandeya Padmashali seva samiti
श्री मार्कण्डेय प‌द्मशाली सेवा समिती

जनगणना फोर्म

Shri Markandey Padmashali Seva Samiti, Jalna.

Admission Form

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Full Name *

Date of Birth*

● Gender * Male Female

Contact Number *

Email Address *

● Home Address *

Parent's/Guardian Name (if applicable) :

Parent's/Guardian Contact (if applicable) :

Father’s Occupation *

Father’s Annual Income *

Mother’s Occupation

Mother’s Annual Income

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Exams (High School)

Exams (Intermediate (12th))

PCB/PCM Class 12th *

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What is your aim in life?? *