1. School name: - SSA Punjab

Page 2 of 2521. Year of establishment of School: ____________________22. Year of recognition of School:Elementary Stage: __________ Secondary stage: __________ Hr. Secondary stage: __________23. Year of upgradation (if applicable):Primary to Upper Primary __ __ __ __Upper Primary to Secondary: __ __ __ __Secondary to Hr. Secondary :__ __ __ __24. Is this a Special School for CWSN? (1) Yes (2) No25. Is the School a Shift School? (1) Yes (2) No26. Is the school residential? (1) Yes (2) NoIf yes, Primary______ Upper Primary______ Secondary______ Hr. Secondary_____(1) Ashram (Govt.) (2) Non-Ashram type (Govt.) (3) Private (4) Others(5) Not Applicable (6) Kasturba Gandhi Balika Vidalaya (KGBV)27. Medium of Instruction :StageMedium of InstructionElementary (Classes I-VIII)Secondary (Classes IX-X)Higher Secondary (Classes XI-XII)i) Hindi (4) ii) Punjabi (13) iii) Sanskrit (14) iv) Urdu (18) v) English (19) vi) Other (99)28. Affiliation Board: (1) CBSE (2) PSEB (3) ICSE (4) International Board (5) OthersFor Secondary sections ______For Higher Secondary sections ______29. Geographical information of the school (if available)(a) Latitude: _____ o _____ '_____ N(b) Longitude: _____ o _____ '_____ E30. Pre-primary section (other than Anganwadi) attached to school : (1) Yes (2) NoIf yes, a) Total students : ______________ b) Total teachers : ___________________________31. Anganwadi Centre in or adjacent of school : (1) Yes (2) NoIf yes, a) Total students : ______________ b) Total teachers / Anganwadi workers : __________32. Last academic year detailsa) No. of academicb) No. of visits by CRCc) No. of visits by Blockd) No. of visits byinspectionsCoordinatorslevel OfficersResource Teachersfor CWSN