The Ashram is an institution founded by Latha Rajinikanth

STUDENT FIRST NAME *

STUDENT MIDDLE NAME

STUDENT LAST NAME

GENDER *

DATE OF BIRTH (DD-MM-YYYY) *

BLOOD GROUP *

RELEGION *

NATIONALITY *

MOTHER TONGUE *

AADHAR NO

MOBILE *

EMAIL

ADDRESS *

CLASS

STATE

CITY *

PREVIOUS SCHOOL NAME

EMIS NO

UPLOAD STUDENT PHOTO *

UPLOAD STUDENT AADHAR CARD *

Please fill in all fields.

Father Details

FATHER NAME

OCCUPATION

EMAIL

MOBILE

Mother Details

MOTHER NAME

OCCUPATION

EMAIL

MOBILE

Guardian Details

GUARDIAN NAME

OCCUPATION

EMAIL

MOBILE

Grand Parents Detail

GRAND FATHER NAME

GRAND FATHER PHONE NO

GRAND MOTHER NAME

GRAND MOTHER PHONE NO

Please fill in all fields.

Child Special Talents

Child attending any extracurricular classes (specify all that applies):

  ARTS
  FINE ARTS
  LITERATURE
  DRAMATICS
  SPORTS

Any Medications given to the child (Specify all that applies)

  INJECTIONS
  VACCINATIONS
  IMMUNISATION
SPECIFY

CHILD HAS ANY HEALTH PROBLEMS

YES
NO
SPECIFY

CHILD HAD ANY MAJOR ILLNESS OR SURGERY RECENTLY

YES
NO
SPECIFY

COMMON MEDICINES THAT SUIT YOUR CHILD

COLD

FEVER

STOMACH UPSET

COUGH

Admission

Admission

Father Details

Mother Details

Guardian Details

Grand Parents Detail

Child Special Talents

Child attending any extracurricular classes (specify all that applies):

Any Medications given to the child (Specify all that applies)

CHILD HAS ANY HEALTH PROBLEMS

CHILD HAD ANY MAJOR ILLNESS OR SURGERY RECENTLY

COMMON MEDICINES THAT SUIT YOUR CHILD