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Requisition PT (UP)

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Name of School : BARISHALI HIGH SCHOOL<br />

Full Address :<br />

Village/Street :<br />

S A R V A S H I K S H A M I S S I O N, B A R D H A M A N<br />

<strong>Requisition</strong> for the payment of Para Teacher's (Upper Primary) upto March-2011<br />

Post Office : KHANDAGHOSH PIN : 713142<br />

Name of the Para Teacher Date of Birth<br />

Educational<br />

Qualification<br />

Sub-Division BURDWAN (S)<br />

Block/MC/MP KHANDOGHOSH<br />

Phone No. Mobile No. (HM or any Teacher) 9474551230<br />

Subject<br />

taken in<br />

Class<br />

DISE CODE : (OLD) 2010102 (NEW) 2010102<br />

SEX<br />

Caste (SC/<br />

ST/ OBC/<br />

Minority/<br />

General)<br />

Date of First<br />

Joininig<br />

Amount claim<br />

(Jan'11 to Mar'11<br />

1 GUR<strong>UP</strong>ADA BAZAR 01/01/1978 GRADUATE MATH MALE GEN 25/09/2004 22275.00<br />

2 JABARANI MONDAL 06/01/1977 M.PHIL OR PH ENG FEMALE GEN 27/09/2004 22275.00<br />

3 JHUMARANI CHAKRABATY 14/01/1980 GRADUATE BEN FEMALE GEN 27/09/2004 22275.00<br />

N. B. : Pending Utilisation Certificate (UC) of all grants including<br />

Para Teachers Salary must be submitted within Nov'10.<br />

[Necessary corrections to be made in this form & corrected form<br />

to be submitted to DPO, SSM Office within 30/11/2010.<br />

Report Print : PARA TEACHER SOFTWARE, Devloped by : MIS Cell, SSM, Bardhaman<br />

Total (X)<br />

66825.00<br />

Received Amount<br />

from 01/04/10 to till<br />

date (should be<br />

date wise)<br />

(A) Due, if any (upto Dec'10) Rs.________________________<br />

(B) Excess blance if any (upto Dec'10) Rs. ________________________<br />

(C) Net amount of claim (X+A)/(X-B) Rs. ________________________<br />

Signature of the Head of Institution<br />

27 September 2010

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