(ii) For Additional/Improvement

Session / Year_____________________

Name of the Candidate (In Punjabi)

Father’s Name (In Punjabi)

Mother’s Name (In Punjabi)

Date of Birth.

District Name

DOB in Words :

1.

2.

3.

Subject Code Subject Name

CATEGORY:-

Desired Centre Name

1. 2.

Regn. No.

FOR OFFICE USE ONLY

SHEET NO.

Centre Code

________________________________________

_____________________________________________

_____________________________________________

Name of the Candidate in English (In Capital Letters)

Father’s Name in English (In Capital Letters)

Mother’s Name in English (In Capital Letters)

Roll

No

Date Month Year

OLD Roll No

T[whdtko dk fpnkBLL- (T) w?A fpnkB eodk$eodh jK fe w/o/ d[nkok ckow ftZu Go/ rJ/ ;ko/ t/ot/ ;jh jB. w?A b'VhAd/ d;skt/i BZEh eo fojk$ojh jK.ckow ftZu ehsh fe;/ th rbs fpnkBhbJh w?A g{oh soQK fizw/tko j'tKrk$j'tKrh. w?A p'ov d[nkok wkBsk gqkgs fe;/ ;z;Ek d[nkok fBekbk-gqkgs eZY/ rJ/ j'D d/ ekoD gohfynk ftZu p?mD s'A tofis BjhA iK p'ov tZb'A fe;/ gohfynk

s'A n:'r eoko BjhA fdZsk frnk. w?A fJ; ftZfdne ;kb ftZu fe;/ th ;oekoh$wkBsk gqkgs ;e{b ftZu BjhA gVQ fojk$ojh jK. w?A fJ; gohfynk ckow s'A fJbktk fJ; gohfynk bJh j'oe'Jh gohfynk ckow BjhA Gfonk.(n) w/o/ tb'A fe;/ th fe;w d/ MrV/ dh ;{os ftZu ekB{zBh ekotkJh e/tb ;kfjpikdk nihs f;zx Bro ;fEs ndkbs ftu jh ehsh ikt/rh.fwshHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHLaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa;EkBHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHT[whdtko d/ j;skyoaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHs;dheL-w?A s;dhe eodk$eodh jK fe T[whdtkoHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa;g[Zso$;gZ[soh ;qhHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH

;qhwshHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaB/ pkothAA dh gohfynk o'b BzLHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa ;?A;B$;kbaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHp'ovHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHs'A fdZsh ;h, fi;dk Bshik HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH j?, gohfynk ckow ftZu Go/ t/ot/ ;jh jB,T[whdtko B/ j;skyo w/oh jkioh ftZu ehs/ jB ns/ fJj T[whdtko fJ; gohfynk bJh :'r j?.‘HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH(g{ok BK )

nj[dkaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHw'pkJhb BzH$N?bhc'B Bzpo e'v ;w/saaaaaaaaaaaaaaaaaaaaaaaa HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH s;dhe eoB tkb/ nfXekoh d/ j;skyo ns/ w'jos;dhe eoB tkb/ nfXekoh d/ j;skyo ns/ w'jos;dhe eoB tkb/ nfXekoh d/ j;skyo ns/ w'jos;dhe eoB tkb/ nfXekoh d/ j;skyo ns/ w'jos;dhe eoB tkb/ nfXekoh d/ j;skyo ns/ w'jo

SENIOR SECONDARY EXAMINATION FORM FOR ADDITIONAL / IMPROVEMENT

2012-13

PUNJAB SCHOOL EDUCATION BOARDPUNJAB SCHOOL EDUCATION BOARD

Deaf & Dumb

Handicapped

Paste RecentWithoutAttested

Passport sizeColoured

Photograph.

DO NOT STAPLE

Address.................................................................................................

...........................................................................................................

Block.......................................Teh.................................Distt...................

Phone Number with STD Code.......................................Mobile No. ...................

Email : ..................................................................................................

Blind

Improvement

SEX

Male

Female

(Particulars in this form are to be filled in by the Candidate after reading the syllabi & instructions)

Medium

Subject Code Subject Name

4.

5.

6.

Punjabi Hindi English

Additional

(iii) For Additional / improvement

7.

8.

9.

Fee Details:- Place:

Fee Amount in Rs

Receipt No.

Dated

Paste RecentAttested

Passport sizeColoured

Photograph.

DO NOT STAPLE

o 'b B zpo HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Ho 'b B zpo HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Ho 'b B zpo HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Ho 'b B zpo HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Ho 'b B zpo HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H o 'b B zpoH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Ho 'b B zpoH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Ho 'b B zpoH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Ho 'b B zpoH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Ho 'b B zpoH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H

B K H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HB K H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HB K H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HB K H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HB K H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H B K H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HB K H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HB K H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HB K H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HB K H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H

fgsk dk BKH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hfgsk dk BKH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hfgsk dk BKH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hfgsk dk BKH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hfgsk dk BKH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H fgsk dk BK H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hfgsk dk BK H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hfgsk dk BK H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hfgsk dk BK H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hfgsk dk BK H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H

gsk H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hgsk H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hgsk H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hgsk H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hgsk H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H gsk H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hgsk H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hgsk H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hgsk H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H Hgsk H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H

H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H HH H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H

fib Q k H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H fg zB e 'vfib Q k H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H fg zB e 'vfib Q k H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H fg zB e 'vfib Q k H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H fg zB e 'vfib Q k H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H fg zB e 'v fibQk a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a H HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHfgzB e'vfibQk a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a H HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHfgzB e'vfibQk a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a H HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHfgzB e'vfibQk a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a H HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHfgzB e'vfibQk a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a H HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHfgzB e'v

If Improvement in Subject with

Practical , Do you want to appear in

Practical Examination again?

SIGNATURE OF CANDIDATE --

In English.......................................................

In Punjabi.......................................................

YES NO

If you are unable to write, do

you want writer ?(Attach Certifi-

cate)

YES NO

Subject Code Subject Name

12

Board_____________________