O’quvchining ijtimoiy-psixologik pasporti (Bolani xaritasi ) Xavf guruhi

O’quvchining ijtimoiy-psixologik pasporti (Bolani xaritasi )


Xavf guruhi:______

Familiya ismi sharifi. ––––––––––––––––––––––––––––––––––––––––––––––

Tug’ilgan sanasi. ––––––––––––––––––––––––––––––––––––––––––––––––––––
Yashash manzili __________________________________________________
Ta’lim olayotgan sinfi________________________________________________
Ijtimoiy yashash sharoitlari __________________________________________
Qiziqishlari, ta’lim olishi, ____________________________________________

To’garaklarga jalb etilganligi _________________________________________

Sog’ligi ahvoli _____________________________________________________

Temperameti ___________________________________________________

O’zlashtirish va ko’nikmalari. _________________________________________

Oila yoki qonuniy vakillari to’g’risida ma’lumot
Onasi:
F.I. Sh. Tug’ilgan yili,____________________________________________


Yashash manzili: _________________________________________________
Tel raqami: ______________________________________________________
Ish joyi: _________________________________________________________


Otasi:
F.I. Sh. Tug’ilgan yili: ______________________________________________
Yashash manzili: ___________________________________________________
Tel raqami: ______________________________________________________
Ish joyi: __________________________________________________________


Qonuniy vakillari


F.I. Sh. Tug’ilgan yili: ____________________________________________


Yashash manzili: __________________________________________________


Tel raqami: _____________________________________________________


Ish joyi: __________________________________________________________