This document is a certificate from the headmaster of a school regarding candidates appearing for SSC public examinations in March 2023. It certifies that the entries in the nominal roll such as names, dates of birth, subjects etc. were made with reference to original records of the school. It also certifies that all eligible candidates as per rules have been included in the nominal roll and private candidates have not been incorrectly marked as regular students of the school. The headmaster takes responsibility for any incorrect entries in the nominal roll.

1. CERTIFICATE
DIRECTORATE OF GOVERNMENT EXAMINATIONS
TELANGANA :: HYDERABAD
1 Certified that all the entries such as name of the candidates, father’s name Mother's name and
date of birth have been made with reference to original admission registers and not with
reference to the atten=
S.S.C. PUBLIC EXAMINATIONS, MAR-23
(SCHOOL DETAILS SHOULD BE FURNISH BY THE HEAD MASTER)
2 The medium of instruction, subjects 1st
2ND
and 3rd
Language have been written with reference to 1 District Name : Jogulamba Gadwal (Dist)
the school records. District Code : 26
3 Certified that the school has been recognized for the academic year 20 - 20 vied RC.NO.---- 2 Name of the School :
-----------dated ------------------- of the Regional Joint Director of school Education/ Director of School code :
School Education , Telangana State, Hyderabad and a copy of which is enclosed to this Nominal Roll School address and PIN code :
4 Certified that all the under aged candidates with condonation orders obtained from competent
authorities have alone been included in the MNR and others deleted.
wrong entries made.
7 Certified that required income certificate issued by the competent authority have been obtained 6 Category :
from all the S.C., S.T. and B.C. candidates as per rules and retained in the office for record duly
indicating the same as ‘’Exempted from fee” in the remarks column of the NR.
Date: 7 Medium wise no. of Candidates :
School Stamp . Signature of the Head of the Institution
School Stamp
8 Examination Fee details
Challan No :
Challan Date :
Total Amount :
Name of treasury/Bank address :
9 Details of the ETR No/ Recognition status : ETR No.
(Copy enclosed)
10 No.of Sections permitted :
Mediums permitted :
Counter Signature
of the Dy.EO / M.EO Concerned
From to
Signature of the Head Master
with School Stamp
REGULAR ONCE
FAILED
TOTAL
TELUGU ENGLISH URDU OTHER
MEDIA
5 (a) Certified that the number of regular candidates sponsored by this school are accordance with 3 School Land Line Number :
the strength and sections permitted by the Government as per recognition orders and as per the 4 Name of the Head Master :
strength with District Common Entrance Board of the District. Mobile No. :
(b) Certified that no private candidates have been sponsored as regular candidates of this school.
6 Certified that all the entries in MNR have been made as per admission register and that I do not 5
Email ID :
No. of Candidates :
claim for any corrections later on at any stage and I am totally held responsible for any type of
BOYS GIRLS TOTAL

2. NOMINAL ROLL FORM (S.S.C), 2022-2023 REGULAR
NAME OF THE SCHOOL
(40 CHARACTERS ONLY)
STUDENTS STRENGTH
SCHOOL CATEGORY 0 1 AREA 0 1
District Code Section Code School Code U-DISE CODE PAGE NUMBER
NR
Serial
No
1st Line- CANDIDATES NAME ( In Capital Letters 42 Characters Only)
( To write in Blue Ink Surname first followed by candidates Name)
2nd Line- Write Fathers Name in 42 Characters 3rd Line- Write Mothers Name in 42 Characters ( To write Both Names in Red Ink )
Sex
(B/G)
Community
Code
P
H
C
Code
Date of
Birth
Regular
Second
Language
Third
Language
Medium
Mathematics
General
Science
Social
Studies
No
of
Subjects
Previous
Roll
No
Remarks
Challan
No./
Date
Date
Month
Year
Group
Code
P
I
P
I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42
1
2
3
4
5
6
7
8
9
10
11
12
Date : SCHOOL SEAL 1NOTE:1) Physically Handicapped Code- (1.DUMB AND DEAF, 2.BLIND,3.ORTHO,4.DYSLEXIA) 2)The Head of th Institution Shall Give a certificate in The Form Appended Overleaf sig of the Head Institution .

3. SSC PUBLIC EXAMINATIONS March - 2023
Failed Candidates (2015 to 2018)
Name of the School :
SSC School Code :
Mandal :
Number of Appeard
Candidates:
Amount Paid :
Challan Number :
Challan Date :
Age Condone Amt:
Challan Number :
Challan Date :
School Stamp
Cell No.
Singnature of Headmaster
TOTAL Appeared Candidates
MEDIUM Boys Girls TOTAL
TELUGU
ENGLISH
URDU
TOTAL
Fee Paid Candidates
Boys Girls TOTAL
Age Condonation
Candidates
Boys Girls TOTAL

4. PROFORMA
SSC Public Examinations - MARCH - 2023
STATISTICS
4 CASTE WISE AND GENDER WISE CANDIDATES PARTICULARS.
CASTE
NO OF CANDIDATES FEES PAID FEEES EXEMPTED
BOYS GIRLS TOTAL BOYS GIRLS TOTAL BOYS GIRLS TOTAL
S.C
S.T
B.C
O.C
GRAND
TOTAL:
P.H.C
Under Age
5
EXAMINATION FEE PAID
FOR ONCE FAILED
CANDIDATES
AMOUNT CHALLAN NO & DATE
Rs.
6 REMARKS IF ANY .
Signature of the Headmaster , with School stamp.
1 SCHOOL CODE :
2
NAME OF THE SCHOOL
& ADDRESS
3
NO OF ONCE FAILED
CANDIDATES
APPEARING :
BOYS GIRLS TOTAL

5. PROFORMA – I
SSC PUBLIC EXAMINATION MARCH – 2023
TO BE SUBMIT ALONG WITH NOMINAL ROLLS
1 SSC School Code
2 Name of the School With Mandal
3 Full Address With Pin code
4 Total No. of Candidates
Boys :
Girls :
Total :
5 *Total No of Students Fee Paid
OC :
BC :
SC :
ST :
Total :
6 Total No of Students Fee Exempted
BC :
SC :
ST
Total
7 Fee Particulars
Challan No. :
Date :
Amount :
8 Age Condonation particulars
No of Candidates :
Challan Num
Date:
Amount :
9 *Name of the Headmaster
10 *Mobile Number
11 Management
Signature of Headmaster with Seal

6. PROFORMA – II
PARTICULARS OF PHYSICAL FACILITIES AVAILABLE IN THE SCHOOL
1 SSC School Code
2
Name of the School With Mandal with
pincode
3 No of Class Rooms Available
4
Maximum Candidates to be
Accommodated to the Examination
5 Furniture available
Dual
Desks
Banches Chairs Others
6
Compound Wall, if not what type of
boundary available
7 Toilets availability separately
Girls Boys Staff
8
Name of the Nearest Post office with
Pin code
9 Name of the Nearest Police Station
10 Medium
11 Name of the Headmaster
12 Whether Gazzetted/ Non Gazzeted
13 Mobile Number
Signature of Headmaster with Seal

7. PROFORMA – III
(PARTICULARS OF THE PRIVATE MANAGEMENT SCHOOL ONLY)
1 SSC School Code
2 Name of the School With Mandal
3 Medium
4 Name of the Correspondent
5 Mobile Number
6
Whether the School Having opening
permission/recognition for the year 2017-
18
Yes/No
7 If so, Particulars of opening Permission
a) Classes with Medium
b) Year
c) RJDSE Proc. Rc. No. & Date
8 Recognition status
a) Type of Recognition Opening/Provisional/ETR
b) Classes With Medium
c) Year
d) No of Sections permitted
e) RJDSE Proce. Rc. No & Date
Signature of Headmaster with Seal

8. SSC Public Examinations - MARCH - 2023
FIGURE STATEMENT FORM
Statement showing the total number of candidates appearing in each Subject
Name of the School: School Code
Boys Girls Total
A.. LANGUAGE SUBJECTS
1 (a)
1st
Language
(Academic
Cource)
Telugu
01T/02T
Hindi
01H/02H
Urdu
01U /
02U
Marathi
01M /
02M
Kanada
01K /
02K
Tamil
01A / 02A
Total
1 (b)
1st
Language
(Academic
Cource)
Urdu
03U
(80)
Marks
Hindi
08H
(20)
Marks
Telugu
03T
(80)
Marks
Sanskri
t
04S
(20) with
Other Combinations
80
Marks
20
Marks
80
Marks
20
Marks
2 2nd
Language
Telugu
09T
Hindi
09H
Urdu
09U
Marathi
09M
Spl
English
11E
3 3rd
Language
Non English Medium: English (T.S) Text
13E/ 14E
B. NON- LANGUAGE SUBJECTS
Subject &
Paper Code
English
Medium
Telugu
Medium
Hindi
Medium
Urdu
Medium
Marathi
Medium
Kanada
Medium
Oriya
Mediu
m
Tamil
Medium
4
Maths
(15/16)
5
General
Science
(19/20)
6
Social
Studies
(21/22)
7
OSSC
(Classical
Oriental
Languages)
Sanskrit
(23/24)
Arabic
(25/26)
Persiam
(27/28)
Signature of the Headmaster with stamp
School Seal

9. Remitter's Name & Address
ð9 9æ త ం ం
ం తð తత3తతæ త& Fee for SSC Public
Purpose for which the amount deposited Exams MARCH - 2019
DDO Code:
Dated:
Head of account verified
Signature of the Remitter
Received Rs.
STO./ Bank Manager
By Cash/DD/Account Credit/Cheque No.
Bank Branch Code
Note: Separate challan should be used for each detailed head
2 5 0 0 0 3 0 3 0 0 1
2 6 0
✃
తత త / TRIPLICATE
Tతతwత తŞ తgð
DTO/STO Jogulamba Gadwal (DTreasury/PAO Code 2 6 0
తw తæ 2
Treasury Challan No.
ãత త
Major Head 0 2 0 2 Education Art, Sports
తత ãత త
Sub Major Head 0 1 General Education
9తgత
Minor Head 1 0 2 Secondary Education
✃
æ త తత త
Group Sub Head
తత త
Sub Head 0 0 6 Director of Govt.Exams.
తæ తతం
ం త త
Detailed Head 8 0 0 User Charges.
తత తæ తతం
ం త త
SUB Detailed Head
Non Plan=N
/Paln=P
N
Charged=C Contingency Fund MH
Voted=V
V Scrvice major Head 2 2 0 2
ðత ం /Amount Rs.
త æ
In words Rupees
తత3£ æ i á , 9 త
ంతత త / DUPLICATE
Tతతwత తŞ తgð
DTO/STO Jogulamba Gadwal (DTreasury/PAO Code 2 6 0
తw తæ 2
Treasury Challan No.
ãత త
Major Head 0 2 0 2 Education Art, Sports
తత ãత త
Sub Major Head 0 1 General Education
9తgత
Minor Head 1 0 2 Secondary Education
✃
æ త తత త
Group Sub Head
తత త
Sub Head 0 0 6 Director of Govt.Exams.
తæ తతం
ం త త
Detailed Head 8 0 0 User Charges.
తత తæ తతం
ం త త
SUB Detailed Head
Non Plan=N Charged=C Contingency Fund MH
/Paln=P
N Voted=V V Scrvice major Head 2 2 0 2
ðత ం /Amount Rs.
త æ
In words Rupees
తత3£ æ i á , 9 త
Remitter's Name & Address
ð9 9æ త ం ం
ం తð తత3తతæ త& Fee for SSC Public
Purpose for which the amount deposited Exams MARCH - 2019
DDO Code: 2 5 0 0 0 3 0 3 0 0 1
Head of account verified
Dated:
Signature of the Remitter
Received Rs.
STO./ Bank Manager
By Cash/DD/Account Credit/Cheque No.
Bank Branch Code
Note: Separate challan should be used for each detailed head
తత త / ORIGINAL
Tతతwత తŞ తgð
DTO/STO Jogulamba Gadwal (DTreasury/PAO Code
తw తæ 2
Treasury Challan No.
ãత త
Major Head 0 2 0 2 Education Art, Sports
తత ãత త
Sub Major Head 0 1 General Education
9తgత
Minor Head 1 0 2 Secondary Education
✃
æ త తత త
Group Sub Head
తత త
Sub Head 0 0 6 Director of Govt.Exams.
తæ తతం
ం త త
Detailed Head 8 0 0 User Charges.
తత తæ తతం
ం త త
SUB Detailed Head
Non Plan=N
/Paln=P N
Charged=C
Voted=V
V
Contingency Fund MH
Scrvice major Head 2 2 0 2
ðత ం /Amount Rs.
త æ
In words Rupees
తత3£ æ i á , 9 త
Remitter's Name & Address
ð9 9æ త ం ం
ం తð తత3తతæ త& Fee for SSC Public
Purpose for which the amount deposited Exams MARCH - 2019
DDO Code: 2 5 0 0 0 3 0 3 0 0 1
Head of account verified
Dated:
Signature of the Remitter
Received Rs.
STO./ Bank Manager
By Cash/DD/Account Credit/Cheque No.
Bank Branch Code
Note: Separate challan should be used for each detailed head

10. PROCEEDINGS OF THE HEAD MASTER
Present :
Rc.No: Dt:
Sub: SSC Public Examinations - MARCH - 2023--
- Condonation of Age for the period of
short fall of age for complation of 14 Years of age - Orders - Issued.
Ref: 1.GO.Ms.No: 40 Edn (Ser V), Dept, Dt: 07/05/2002
2.Govt.memo No: 17120 / Exams /2004, Edn.(SE Exams),
Dt: 08-06-2006.
Order
In accordence with the instruction issuid in the Govt. Memo No. 195/Edn,dt.
28-7-97, communicated in proceedings Rc. No. 109/B 2/99 dt. 3-1-2000 by the
Director of Government Examination, the Gazetted Headmaster
is pleased to grant age condonation to the
following condidates forthe period of short fall of age as mentioned against the
names of the candidates forthe complation of 14 years of age as on 31-08-22 for
appearing SSC PublicExaminations,-MARCH - 2023
Sl.
No
NR
Sl No
Name of the candidate Father's Name
D O B
DD-MM-YY
Age as on
31-08-19
YY-MM-DD
Age
exmpted
YY-MM-DD
1
2
3
4
5
6
7
Condonation Fee Rs. /- Challan No. Date. - -20
Certified that each student has remitted an amount of Rs 300 /- vide
Chanlan number as mentioned above list, to the Govt. account.
Gazetted Headmaster
Copy submitted to .
The DGE, Telangana, Hyderabad.
The District Educational Officer, Jogulamba Gadwal.

11. SSC PUBLIC EXAMINATIONS MARCH - 2023
Name of the School :
SSC School Code :
Mandal :
Number of
Candidates:
Amount Paid : Age Condone Amt:
Challan Number : Challan Number :
Challan Date : Challan Date :
School Stamp
Cell No.
Singnature of Headmaster
Age Condonation
Candidates
Boys Girls TOTAL

12. FROM To,
District Educational Officer
Jogulamba Gadwal
“ Through proper channel”
RC NO : Dated :
Sir/Madem,
Sub : SSC - March - 2023 - Submition of MNR'S, Online Application forms and
Original Challan –for onword transmission to the DGE HYD.
Ref: DGE , HYD, (TS), Rc No. 150/B-2/2019 Dt: 29-10-2022
****************
In regard with the above cited subject Iam herewith submitting the MNRs of
Failed candidates (2015-18) of for SSC
Public Exams March 2023 along with the following enclosures
NO OF
REGULAR
CANDIDATES
APPEARING :
MEDIUM BOYS GIRLS TOTAL
TELUGU
ENGLISH
URDU
TOTAL
Bunch – I
1) MNR of Regular candidates –
2) Original Challan No :- Date :
3) Amount : Candidates:
4) List of candidates who paid SSC Examination fee –
5) List of Hostel Boarders-
8) Figure Statement – 01
Yours faithfully,

13. FROM
,
To,
District Educational Officer
Jogulamba Gadwal
“ Through proper channel”
RC NO : /SSC/ 2023 Dated :
Sir/Madem,
Sub : SSC - March - 2023 - Submition of MNR'S, Online Application forms and
Original Challan –for onword transmission to the DGE HYD.
Ref: DGE , HYD, (TS), Rc No. 149/B-2/2022 Dt: 09-10-2022
****************
In regard with the above cited subject Iam herewith submitting the MNRs of
OFC June candidates of for SSC
PublicExams March 2023 along with the following enclosures
NO OF
REGULAR
CANDIDATES
APPEARING :
MEDIUM BOYS GIRLS TOTAL
TELUGU
ENGLISH
URDU
TOTAL
Bunch – I
1) MNR of Regular candidates –
2) Original Challan No :- Date :
3) Amount : Candidates:
4) List of candidates who paid SSC Examination fee –
5) List of Hostel Boarders-
8) Figure Statement – 01
Yours faithfully,

14. MEDICAL AGE FITNESS CERTIFICATE
This is to Certify that
S/O, D/O studing 10th class in
is
physically and mentally has proper fitness to write SSC Public
Examinations MARCH - 2023 and his / her Date of Birth is
Place:
Date:
Sign of the
Medical Officer

15. FROM To,
District Educational Officer
Jogulamba Gadwal
RC NO : / 2023
“ Through proper channel”
Dated :
Sir/Madem,
Sub : SSC - March - 2023 - Submition of MNR'S , Online Application forms
and Original Challan –for onword transmission to the DGE HYD.
Ref: DGE , HYD, (TS), Rc No. 149/B-2/2022 Dt: 29-10-2022
****************
In regard with the above cited subject Iam herewith submitting the MNRs of
regular candidates of for SSC
Public Exams March 2023 along with the following enclosures
NO OF
REGULAR
CANDIDATES
APPEARING :
MEDIUM BOYS GIRLS TOTAL
TELUGU
ENGLISH
URDU
TOTAL
Bunch – I
1) MNR of Regular candidates –
2) Original Challan No :- Date :
3) Amount (With Fine): Candidates:
4) List of candidates who paid SSC Examination fee –
5) Figure Statement – 01
Yours faithfully,

16. PROFORMA
SSC Public Examinations - MARCH - 2023
STATISTICS
4 CASTE WISE AND GENDER WISE CANDIDATES PARTICULARS.
CASTE
NO OF CANDIDATES FEES PAID FEEES EXEMPTED
BOYS GIRLS TOTAL BOYS GIRLS TOTAL BOYS GIRLS TOTAL
S.C
S.T
B.C
O.C
GRAND
TOTAL:
P.H.C
Under Age
5
EXAMINATION FEE PAID
FOR REGULAR
CANDIDATES
AMOUNT CHALLAN NO & DATE
Rs.
6 REMARKS IF ANY .
Signature of the Headmaster , with School stamp.
1 SCHOOL CODE :
2
NAME OF THE SCHOOL
& ADDRESS
3
NO OF REGULAR
CANDIDATES
APPEARING :
BOYS GIRLS TOTAL

17. DISTRICT : JOGULAMBA GADWAL
NAME OF THE MANDAL :
NAME OF THE SCHOOL :
LIST FOR SSC HANDILING SUBJECT TEACHERS SCHOOL CODE :
UDISE CODE:
Sl
NO
Tresary ID Name of the Teacher Designation Subject Medium
Handiling
Eng
Medium
Date of Birth
Date of first
Appointment
Date of joining in
present post
(HM/SA/LP/Others
) (DD/MM/YYYY)
Subject
handling
from last 3
years
X Class
handling
experience
(Years)
Mobile No. Remarks
1 2 3 4 5 6 7 8 9 10 11 12 13 14
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15