«tasdiqlayman» 19-sonli umumiy o‘rta talim maktabi direktori: O. Sadiqov

Yashash sharoitlari:
- kommunal kvartirada (soni) ___________________________________________________
- alohida kvartirada ___________________________________________________________
-mahalla, xonadonda ___________________________________________________________
- dars xonasi mavjudmi? _______________________________________________________


O‘quvchilarning bilim darajasi: ______________________________________________
namunali,yaxshi, qoniqarli, qoniqarsiz
Ota-onalarining ma’lumot darajasi:
- oliy ma’lumotli ____________ota ______________________ ona____________________
- o‘rta maxsus __________________________________________________________________
- o‘rta ________________________________________________________________________
-to‘liqsiz o‘rta ________________________________________________________________
- ilmiy darajasi bor __________________________________________________________
Tarbiyasi og‘ir o‘quvchilar (soni, ismi sharifi) ___________________________________
Sinfning milliy tarkibi (soni) ______________________________________________


O‘quvchilarning salomatlik holati: ____________________________________________
- yakka tartibda o‘qitiladi (ismi sharifi) ________________________________________
- xronik kasallangan ___________________________________________________________
- ko‘rish holatlari _____________________________________________________________
- boshqalar ___________________________________________________________________


O‘quvchilarning maktabdan tashqari ta’limga jalb etilganligi:
- musiqa maktabida ____________________________________________________________
- sport sektsiyalari, klublarida __________________________________________________
- teatr studiyalarida ___________________________________________________________
- ijodiyot markazlarida va boshqa faoliyat turida __________________________________
- fan to‘garaklarida ____________________________________________________________
(va hokazo)