FORM 19C

(See Rule 3)

GOVERNMENT OF KERALA
KODUVAZHANOOR VILLAGE OFFICE
ONE AND THE SAME CERTIFICATE
No. 69185255 Date: 26/09/2022

Name of Person to whom certificate is

MEGHA MOHAN L
issued
Gender Female
Age 26

Name of Father MOHANDAS S

Address PANDIYANVILA VEEDU, 382, PULLAYIL

Post Office with Pin code PULLAYIL P O, 695601

A mole near the upperlip

Identification marks
A mole on the right foot

Name of Localbody Pulimath

Village Koduvazhannoor
Taluk Chirayinkeezhu
District Thiruvananthapuram
Certified that the above person is also known in the following names and that the person is one and the same.
1. Gouri Sankaram
Alias Names 2. Pandiyanvila Veedu
Date of Issue of Certificate 26/09/2022
Designation of the issuing officer VILLAGE OFFICER
Remarks Nil
This certificate is issued based on the details given in the application, local enquiry, facts and records
produced and is valid for lifelong.

Security Code : D8N7K

NOTE:

1. This digitally signed document is legally valid as per the Information Technology (IT) Act, 2000.
2. Authenticity of this document can be verified from http://edistrict.kerala.gov.in/ and submitting the Certificate Number and
Security code. Alternatively, please call the numbers 155300(from BSNL landline), 0471155300(from BSNL mobile),
04712335523/04712115094/04712115098(from other networks) and quote the Certificate Number to the operator.