hei AE
wi
E NO. ES FATHER MOB.NO: SMR
VCNC *.* 1FSC CODE...A MK REdaLY.
ADHAR CARD NC
10. NOMINEE NAME RELATION
11. ADDRESS
VILL Ramhader...0AdLkardhs.cAa POST eS Lb SAYA elk Ad
TEHSIL Abeabg ah. DISTRIC 2 000f-. 22.64.
STATE f PIN CODE NO 4WO.O4 4).
12. QUALIFICATION A.2,.15
-PASSING YEAR LAL,
13. ROOM LOCATION :-
I HEREBY DECLARE THE ABOVE PARTICULARS HAVE BEEN GIVEN BY MI
CORRECT TO THE BEST OF MY KNOWLEDGE.
(SIGN. Of E