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INl 0MI TAJ Dt1.AKTMENT

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GOVT. OF INDIA
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JIION PAilR
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LAKNSIIANSING PATIR

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Kiron Patir
di-ll<t ~~ I DOB: 31/12/2001
W- / Male

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•--~ -~~ 0.': .'f. \ ... District Unit I
Regd .No.5 04/19 76 -77 I
H.O .Triba l Rest House ,Solap ar I
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Paltan bazar,G uwah ati-8 I
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: SI. No5 7 8 7 5 • ~ . :
CASTE CERTIFICATE ~~ •• I
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: This is~ to Certify that Sri/ Miss / Smti. ... n-r..o..>0......l.~ .l-X':-P.!X ...........
.
?..a°L·.x ..................
r L • •
Son of/ Daughter :
~ \... I
I f S n. / late . C) T·
. s :m.~>I\.Ss.~ ····:rQ.,..... ~.::r...... Son of I Daught er of Smt1/La te ..~ x:\
.e1 ..
-tn~ ......... c::.~.:- r....... .
I o
I in village rrown .~ . L . - l.O. ...........\?~,j\x.....................P.O.....~..Y.\.Q .............P.Q."'~,\r.............
.........................
1 P.S...Db.~ ~~~............District. ... d:.-a-$.~I.ID-:............................. in the state of Assam belongs
to Scheduled Tribe Caste I Community......M~1.~\l.lNf·..........( ..6i.:;.:-,;.") ...................recognised
as Scheduled Tribe (Plains)
) ORDER 1956 & SC / ST
under the Constitution of India (Scheduled Tribe) cJRDER 1950 as amended (modification
ORDERS (Amendment)Acl 1957,SC/ST ORDERS (Amendment Act2002 .
Sri/ Miss I Smti ... t .Y.C!\.b .......t,v..~ ............ P.~.f f:·c.......
and his / her family ordinarily resides in
·~'½J·~ ·····..···pa.:\;.Y........... P.0 .... ~ .M~ ...•..P.Q:~~.~ ... P.S.. ~~~q_
Village/Town .
District ..~~w✓. ................. in the state of Assam .