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a) f{rqffqrf,q t mdq qr* orrqffit o} mqp*, fr qrtft I

oTr-ilfi q=r srq dri offrq ftfU ffio, zo / t't / zozs

6.t efr ffi-qr6q,wddf{

7
sn-ilfi rE{ qr6"r qr-do- (Tfr'q ,rft) td
qft, qrs-+C
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qclrilErrT iE-s Efr ffi-qraq, qA-{ qq
qE-d5q 1.Xq qH
q-S frq-nt
t. fieft,rffrziftsft ,ffi WlT tg,
$ fteTrl d,Tri
z. eTr-il{o' or qFr - fr7ffi7q0
3. ftrqrzsex (sfr qfi fr f./l Affi dqri) guv/tvtale d/Female
4. fr-dT/qft 6-r nF{
s. Eq ffio. -................. Ro o1 eilg ..........q{ .........qr6 .........k{
6. ffi 7dd-rft-Gr-{Rkf, On) /erqr (sc) /oh,Mr (sr) /slfrq (oBC) /oTrf$6 $q t
srsN qrf (Bws)
(lsri ti B-d-s Ftl
7. qrr oilq qtq tr+yr d aa ffi B ? (Er qi q-tr s-mq t)
8. TeTf$ q-fl/Permanet Address
(funr, q-tsr Tq Ms qkir)

9. q?il'qN ql qm/ CorrespondenceAddress


(fuor, q-ivr sq ffi qtrd)
ro. q)-qr{f,,2q}q rq{
rr.tq.nq olqfd-q or qr+T f,QrT
frBf, ftfi=q-{ m-qro.
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TI. qfteTr or qH frqq v(ffi M HKi-m) e)d7ro^a
fr. o-G or o-I ,/Tr{arf
q{ q-frrTd
1

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A-s-dT fu{in
m-qsl:
(z)

14. ergrq Ed flart qrfr qrrr a-f,rt or st-$ro s-qrq wr (frffi fi qnsfrtqZ
swrq of frrrni rys
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rs. frfuo *il-n or fq-+Eq -


lf. F I]IIFT .F-I Tlrl 5dlrfr E=qffi gg
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ro. daq 6-l


{{. m- tio or qTqlEd.€H q qRr s R{i-n
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+c :- S{lul l]-iTr{ 4-$IT


17. s6rq r,rrq qeT at Efr -
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oroi/osft ( fu Gtrifi ti fr .T{ wrrt<T qr{f,rft delT fuflur WIo, $-cq t
q-a t

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oTra-fi tra frrE< fu-qr qr sdrT t fufra qqqE qR qn-fiT-ft .re-o qr{ rnrft t fr
ffi vq( et qr sfrrft aen tt fr-s€ ftn-fun ,nffi d ftrt ffiqrnq o1 Wi
GTko-R *m t

fu{io
{E]T;I
enilqo d rwrerq
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sh
Ef,flfrrq,
q+r{-o or
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qH
q-q-dgq .r1q
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1. oTf-il{f, or fl-q - +fr/+ffi/Eo
z. fri-rr,/sex (wfi qfi q t{l Aq-H d'n-$) guv/Male r*/ remale

3. fr-dT/qfr ot nFI
4. wq ftffi{ -................. fto o\ eng ..........qS .........qr6 .........fu{

s. 9ffi/d-ffi-GffiR|6f, ruR) /31sil (sc) /31\,151r (sr)/3Tfr-q (oBC) /3TIf*6 tq t


o-q-ft q.f (Ews)
(qrt ti B-dq ot)
6. T{ir oTIq qtq trAqr d 5o ffi B ? (6r qr r$t s-oq t)
7. Tnlf{ qfl/Permanet Address
(fuf,r, trtqT \q ffis
Hkd)

8. q?il=IN q qm / Correspondence Address

(fuf,r, TAqr gq ft-q-ols qtrd)


s. fqrs-dZmt{ qqq
ro. qtqqn m-rqfd-q o-r qrrl dQrT

frfun tr$-fi m-qi6


,,.giqTFI-6 qlr{f,r @-r ldflur -
s. o-I qTII ftq-q B-tr M qwrmi eldTro^a
fr. ost mr o-T /\{{ar
qd q.frrTd

3.

rz.frBo ffi or f++sq -


{{. ffi. l]flq o-t qFI 5dlg* c-q frqifr gq
1

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m-{ql:
(z)

rr.der.q qrffigfl/\-{ffi/i-c thtq ol fu+qoT -


H. m' q =wt/ q qifu s k{i-6
1

de - vqpr qcTr{ O1=IT

r+.riarq u-,Irq r{i @t q* -

dIqqT-rra
q GTrcrq/GTrcrqTZqH q6 q)qtr

osm/osft ( fu eililfi qa fr ft G fuflur ry16: vcu B


sslfiT qn-fiT-fr oelT t

qt iqr
sq-tffi cno-rt d ftd q rqri B-trTflS r$rTlr{ft 1 qn-orfr or{riq qr} sri
eTr-ilfi qa ftrs< fu-w ur rr#TT I ftgfu q{qrq qfr ulroTtr
qao qr$ qrft B dl
Ftrfrn rq< o1 qr rrd.ft oen tt fr-s€ atrrP{6.o1ffi d ftrn frroB-qrd-q ef Y$
Grftm-N etn t

ft-{im
{affT
Glr'ffo d rg<ra-q
T{r fl-q......

orqfo-q 7fuwr / trTq of ftmrfts or{q Htra

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