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Case History
Details about students / professionals for Counselling Session
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* Indicates required question
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MM
/
DD
/
YYYY
Name of the student
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Your answer
Age
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Choose
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Choose
Male
Female
Father's Occupation
*
Your answer
Mother's Occupation
*
Your answer
Address
*
Your answer
Mobile No.
*
Your answer
School / College / Organization
*
Your answer
Standard
*
Choose
VIII
IX
X
XI Science
XI Commerce
XI Arts
XII Science
XII Commerce
XII Arts
Masters
Bachelors
Drop Out
Others
Percentage of Previous Class
*
Your answer
Non - Favorite Subjects
*
Your answer
Favorite Subjects
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Your answer
Any Academic or Non-Academic Achievements
*
Your answer
Aspirations – Dream Career
*
Your answer
Where you want to see yourself after 5 -10 years ?
*
Your answer
Your Strengths
*
Good with people/ Team work
Cool & Calm
Good Communication Skills
Technical person/IT
Sports person
Disciplined
Observation power
Problem Solver
Negotiation skills
Others
Strengths
Good with people/ Team work
Cool & Calm
Good Communication Skills
Technical person/IT
Sports person
Disciplined
Observation power
Problem Solver
Negotiation skills
Others
Strengths
Your Weakness
*
Not good with people / No team work
Short Tempered
Not Disciplined
Stage fear
Lazy person
No communication skills
Lack of Attention
Overthinking
Lack of Patience
Dependent
Others
Weakness
Not good with people / No team work
Short Tempered
Not Disciplined
Stage fear
Lazy person
No communication skills
Lack of Attention
Overthinking
Lack of Patience
Dependent
Others
Weakness
Your Hobbies & Interest
*
Your answer
Anything Interesting About You
*
Your answer
Name any Indoor/Outdoor Sports you like to play
*
Your answer
How much time you devote to Social media / Mobile Phone?
*
Your answer
What kind of Movies or Videos you prefer?
*
Action
Comedy
Horror
Mystery
Thriller
Romance
Real Story Based
Cooking
Family oriented
Others
Movies
Videos
Action
Comedy
Horror
Mystery
Thriller
Romance
Real Story Based
Cooking
Family oriented
Others
Movies
Videos
What type of Books/Magazines you prefer ?
*
Fictional
Non-Fictional
Mystery
Adventurous
Thriller
Horror
Literary / Historical
Fairy Tales
Contemporary
Others
Books
Magazines
Fictional
Non-Fictional
Mystery
Adventurous
Thriller
Horror
Literary / Historical
Fairy Tales
Contemporary
Others
Books
Magazines
Favorite Color
*
Your answer
Favorite Food
*
Your answer
Other things you want to share
*
Your answer
From where you wants to complete your Higher Education
*
Study in India
Study Abroad
Both in India and Abroad
Others
Reference / Counsellor Name
*
Your answer
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