LEARNER'S LICENCE

Form 3
[See Rules 3(a),13]

Licence No. OD11 /0008793/2023

Issue Dt. 29-09-2023
Fee Details: Rs.250.0/- /ODW/871630 etc /21-09-2023
1. Name NIHARIKA SAHU
Husband Name SUMIT KUMAR BASA
2.
3. Date of Birth 17-06-1997

4. Blood Group A+
5. Present Address AT-RAGHUNATHPUR WARD NO-22 BARIPADA Baripada
Town,Mayurbhanj,OD,757107
6. Permanent Address AT-RAGHUNATHPUR WARD NO-22 BARIPADA Baripada
Town,Mayurbhanj,OD,757107
7. Marks of Identification (1)
(2)
Specimen Signature/Thumb impression of
8. Qualifications Graduate in Non Medical Sciences the holder of the Licence
is licenced to drive throughout India as a learner subject to the provisions of rule 3 of the Central Motor Vehicles Rules 1989, a motor
vehicle of the following description
*The holder of the licence has exempted from the medical test under rule 6
MCWOG,
....................................................................................................................................................
*The holder of the licence has passed the Preliminary test under rule11(1)of the Central Motor Vehicle Rules,1989

*Strike off which ever is inapplicable

This Licence is valid from 29/09/2023 To 28/03/2024

Licensing Authority
Warning: RTO,MAYURBHANJ
The attention of the holder of this licence is drawn to rule 3 of CMV Rules, 1989 which prohibits him from driving any motor vehicle unless
he has besides him a person duly licenced to drive the vehicle and in every case , the vehicle carries "L" plates both in front and in the rear
of the vehicle.