WE SERVE TO SAVE

Gujarat State Institute for Fire Safety Training,

Gujarat State Fire Prevention Services
GIDM Campus, ERC Koba-Gandhinagar Road, Raysan,
Behind PDPU, Gandhinagar - 382007 (Gujarat)
E-mail : dir-sfps-gnr@gujarat.gov.in

FORM B 12

(See sub-rule (2) of rule 21)

CERTIFICATE OF ENROLMENT OF FIRE SAFETY OFFICER (SPECIALIST)

Enrollment No : FSOS/2021/000437

Certified that below mentioned candidate

Name : Brij Nandan Bhatnagar
Father Name : Nandan
Resident of : A-403,
Sanidhya Flora,
Chankheda, New Cg Road, Tp 44, Chandkheda, Ahmedabad City
West, Ahmedabad, Gujarat - 382424
ǁŚŽƐĞററƉŚŽƚŽŐƌĂƉŚററĂƉƉĞĂƌററŽŶററƚŚĞററƌŝŐŚƚററĐŽƌŶĞƌററŽĨററƚŚĞററĐĞƌƚŝĨŝĐĂƚĞ͕ററŚĂƐററďĞĞŶററĞŶƌŽůůĞĚററĂƐററ&ŝƌĞററ^ĂĨĞƚLJററKĨĨŝĐĞƌററŝŶററ
ƚŚĞറĐĂƚĞŐŽƌLJററററ&^KററററͲററററ^W/>/^dററററĨŽƌററററƚŚĞററററƐƚĂƚĞററററƵŶĚĞƌററററ^ĞĐƚŝŽŶററററϭϮറററŽĨറററdŚĞറററ'ƵũĂƌĂƚറററ&ŝƌĞറററWƌĞǀĞŶƚŝŽŶറററĂŶĚറററ
>ŝĨĞറററ^ĂĨĞƚLJDĞĂƐƵƌĞƐറററ;ŵĞŶĚŵĞŶƚͿററĐƚ͕ററϮϬϮϭററററĨŽƌററĂററƉĞƌŝŽĚററŽĨററƚŚƌĞĞററ;ϯͿററLJĞĂƌƐററĨƌŽŵററƚŚĞററĚĂƚĞററŽĨററĞŶƌŽůŵĞŶƚററ
ĂŶĚററǀĞƐƚĞĚററǁŝƚŚƚŚĞƉŽǁĞƌƐĂŶĚƌĞƐƉŽŶƐŝďŝůŝƚŝĞƐŐŝǀĞŶƵŶĚĞƌƚŚĞĐƚĂŶĚƚŚĞZƵůĞƐ͘

/ŶറററƚŚĞറററĞǀĞŶƚറററŽĨറററĂŶLJററĐŽŵƉůĂŝŶററŽƌററĨŽƌററĂŶLJററŽƚŚĞƌററƌĞĂƐŽŶƐററƌĞĐŽƌĚĞĚററŝŶററǁƌŝƚŝŶŐ͕ററƚŚĞററŝƌĞĐƚŽƌററŵĂLJററĐĂŶĐĞůററƚŚĞററ
ĞŶƌŽůŵĞŶƚററĂŶĚƚĂŬĞĂĐƚŝŽŶƵŶĚĞƌƚŚĞĐƚĂŶĚƚŚĞZƵůĞƐ͘

Place : Gandhinagar
Date of Enrolment : 21 Oct 2021

Signature Valid
Electronically signed by:
K N Bishnoi
Director
Gujarat State Fire Prevention Services

Date & Time: 21/10/2021 2:48:40 PM

 WE SERVE TO SAVE
Gujarat State Institute for Fire Safety Training,
Gujarat State Fire Prevention Services
GIDM Campus, ERC Koba-Gandhinagar Road, Raysan,
Behind PDPU, Gandhinagar - 382007 (Gujarat)
E-mail : dir-sfps-gnr@gujarat.gov.in

FORM B 12

(See sub-rule (2) of rule 21)

CERTIFICATE OF ENROLMENT OF FIRE SAFETY OFFICER (SPECIALIST)

This is a digitally Verified / Signed certificate, hence doesn't require physical signature. To validate authenticity of this
certificate, scan the QR code or search the FSO details in appropriate section at www.gujfiresafetycop.in