<p> Sheet ……….. of ………….</p><p>Student Data Capture Format (in sync with U-DISE) Help Desk (Toll Free): 1800-11-6200 District Name: Prakasam Mandal name: Village name Section: ______Academic Year: 2016-17</p><p>U-DISE Code (11 digits)</p><p>Sl. Variable name Student 1 Student 3 Student 4 Student 5 Student 7 Student 8</p><p>I Child Address</p><p>1 Student's AADHAAR type(Aadhar / Aadhar EID)</p><p>2 Aadhar Number</p><p>3 District name</p><p>4 Mandal Name * 5 Revenue Village Name * 6 Habitation Name * 7 Sur Name* 8 Name*</p><p>9 Gender * (Boy /Girl/ Others)</p><p>10 Father’s Name* (Full Name)</p><p>11 Mother’s Name* (Full Name)</p><p>12 Date of Birth (DD/MM/YYYY) * 13 Mobile Number (of student/parent) </p><p>14 Caste (OC=1,SC=2,ST=3, BC=4) 15 Sub Caste(BC-A,BC-B,BC-C,BC-D,BC-E) </p><p>16 Religion* (Hindu/Muslim/Christan)</p><p>17 Mother Tongue* 18 Disability* 19 Facilities received by CWSN 20 Email Address (of student/parent) 21 Child belongs to *(Rural, Urban, Tribal Area) Is Staying At Hostel* 22 (Yes/NO) 23 If yes Hostel Type Whether belong to Disadvantaged 24 Group*(Y/N) No. of days’ child attended school 25 (in the previous academic year) * II Other Details 26 Height(cm) 27 Weight(kgs) 28 Parent Literacy Status (Illiterate/iterate) 29 IF Literate*(below SSC, SSC or above SSC) 30 Socio economic status of the child </p><p>Sl. Variable name Student 1 Student 3 Student 4 Student 5 Student 7 Student 8</p><p>31 Child Is having Insurance (Yes/No) Sheet ……….. of ………….</p><p>32 Distance from Home to School(km)</p><p>33 Mode of Transport:</p><p>34 Child Blood Group</p><p>Facilities Provided to the student III (for Govt./Aided school) No. of uniform sets 35 (none/One Set/Two Sets/partial) 36 Complete set of free Text Books</p><p>37 Free Transport</p><p>38 Free Escort facility 39 MDM beneficiary 40 Free Hostel facility </p><p>41 Child attended Special Training? Tablets Received in the last 3 months IV (for Govt./Aided school) 42 Iron & Folic acid (NA /YES / NO)</p><p>42 Deworming tablets (NA /YES / NO)</p><p>43 Vitamin-A tablets (NA /YES / NO)</p><p>V Last examination details 43 Last examination appeared* (NA /YES / NO) 44 Last examination passed* (NA /YES / NO) 45 Last examination % of marks obtained*</p><p>VI Admission Details</p><p>49 Date of Admission* 50 Admission Number* 51 Medium * (Telugu / English) 52 First Language 53 Second Language 54 Present, Studying in Class* 55 Section *(A, B,C,D,NONE) 56 Class studied in previous year* 57 Class in which Admitted*</p><p>Signature of the Headmaster</p><p>Seal Sheet ……….. of …………. Description of the variables with possible values Sheet ……….. of …………. Sl.No Variable Name Definition and possible values 1 Aadhar type Aadhar / Aadhar EID Write the 12 digit AADHAAR number /EID Number of the Student. AADHAAR number will be 2 Student's AADHAAR Number validated with the UIDAI database 7 Sur name Write Full Surname of the Student (as mentioned in the Admission form/register) 8 Name of the student (Full Name) Write Full name of the student (as mentioned in the Admission form/register) 9 Gender Write Boy=1, Girl=2, Others 10 Father’s Name (Full Name) Write Full name of student’s father (as mentioned in the Admission form/register) 11 Mother’s Name (Full Name) Write Full name of student’s mother (as mentioned in the Admission form/register) 12 Date of Birth (DD/MM/YYYY) (Date/Month/Year). Eg. (22/01/2015) 14 Caste Write /Caste (as mentioned in the Admission form/register) OC, SC, ST, BC 15 Sub caste Write /Caste (as mentioned in the Admission form/register) BC-A, BC-B, BC-C, BC-D, BC-E 16 Religion Hindu, Muslim, Christian, Sikh, Buddhist, Jain, Others: As defined in the state Please write the language: Telugu, Urdu, English, Tamil, Kannada, Marathi, Oriya, Guajarati, 17 Mother Tongue Others, None</p><p>18 Type of Disability Visual (Blindness), Visual (Low-vision), Hearing Impaired, speech, Loco motor, Mental Retardation, Learning disability, Cerebral Palsy, Autism, Multiple disabilities, A Not Applicable, Braille books, Braille kit, Low vision kit, Hearing aid, Braces, Crutches, Wheel 19 Facilities received by CWSN chair, Tri-cycle, Calliper, Others 21 Child belongs to rural area, urban area, tribal Area</p><p>22 Is studying at Hostel Yes/No BC Welfare Hostel / SC Welfare Hostel / ST Welfare Hostel / Minority Welfare Hostel / Girls 23 If yes Hostel Type Hostel(RMSA) / Others / KGBV Hostel Yes=1, No=2: As defined in state RTE rules (Disadvantaged Groups like, the Scheduled Castes (SCs), the Scheduled Tribes (STs), the Other Backward Classes (OBCs) and the 24 Whether belongs to Disadvantaged group Minorities, as they still continue to lag behind the rest of the society due to their social and economic backwardness.) Total number of days the child attended the school in previous academic year. This information 25 No. of days child attended school in previous year can be obtained from the Attendance register. II Other Details 28 Parent Literacy Status* Illiterate / literate 29 If Literate* Below SSC / SSC or Above SSC 30 Socio economic status of the child* White Card Holder – BPL / Non BPL 31 Child Is having Insurance Yes / No</p><p>32 Distance from Home to School(km) Below-1,1-km, 2km, 3km, 4km, 5km, Above-5km</p><p>33 Mode of Transport By walk, bicycle, Auto, Bus, others</p><p>34 Child Blood Group A+ / A- / B+ / B-/ AB+ / AB- / O+ / O -</p><p>III Facilities Provided to the student (Govt.Aided) Number of uniform sets the child received. (for 35 No. of uniform sets (None / One Set / Two Sets /partial) Government) NA /YES / NO (Whether the child got complete set of text book. (for Government / Aided 36 Complete set of free Text Books school) NA /YES / NO Whether the child gets free transport facility to reach to the school. (for 37 Free Transport Government) NA /YES / NO Whether the child gets free escort facility to reach to the school. (for 38 Free Escort facility Government) 39 MDM beneficiary NA /YES / NO Whether the child receives Mid-Day Meal. (for Government / Aided school) 40 Free Hostel facility Not Applicable / KGBV / Non KGBV(Government) / Girls Hostel / Others / None Not Applicable / Residential / Non Residential (Whether the child has undergone Special 41 Child attended Special Training? training. (for Government / Aided school) VI Admission Details Write the Date of admission in this school in the (DD/MM/YYYY) (Date/Month/Year). Eg. 49 Date of Admission (22/01/2010): 50 Admission No. Write the Admission serial number given to the child at the time of admission in this school 54 Studying in class 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, The class in which the child is studying in the current year Sheet ……….. of …………. 56 Class studied previous year 1, 2, 3, 4, 5, 6, 7, 8, 9, 10</p>