第         号
                卒業証明書交付願
                                                                     契
                          平成          年          月          日   印
                                                                                   卒 業 証 明 書
 愛知県立瀬戸西高等学校長¹        殿
                                 昭和
                                 平成        年 普通 科卒
                       氏名                                                                      氏名
                       昭和                                                                      昭和
                       平成            年         月          日生                                        年        月        日生
                                                                                                 平成
 
 下記により卒業証明書を交付してください。
                                                                                         昭和
                                                                            上記の者は 平成         年         月             日
                            記
 
 1   理由                                                                本校   普通   科を卒業したことを証明する。
 
 
 
 
                発   行          台         帳                                                   平成     年        月        日
 
      決   裁   欄
 
      発行番号         第                           号                      愛知県立瀬戸西高等学校長²                     印
 
      発行年月日     平成         年         月          日
 
      取扱者印