केन्द्रीय विद्यालय : कक्षा - दशमी  
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छात्रस्य नाम  ( Name of Students ) *
विद्यालयस्य नाम स्थान च  (School Name & Place) *
अनुक्रमाङ्कः   (Roll No.)
कक्षा  (Class) *
दूरभाष अङ्कः  (Mobile No.) *
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