Government of Karnataka

For information on those concerned

Mr. / Ku / Mrs AMRUTA C BURJI , Female, Age 21 Years, SRF ID 2952700417147,

COVID19 for Belgaum Institute of Medical Sciences BIMS Belgaum Karnataka
Tested in and 2021-01-12 From the Lab NEGATIVE Has been declared.

ಕ ಾ ಟಕ ಾಜ ೂೕ ಯುದ ೂಠ
ಕ ಾ ಟಕ ಸ ಾ ರ

(ಇದು ಟ ರೂಪದ ರ ಸ ಾದ ವರ ಾ ಮತು ಹಸ ಾ ತ ಸ ಗಳ ಅಗತ ಲ. ೕವ

ಫ ಾಂಶವನು https://www.covidwar.karnataka.gov.in/service1 ನ ಖ ತಪಡಸಬಹುದು)

GOVERNMENT OF KARNATAKA

To Whomsoever it May Concern

Mr/Ms/Mrs. AMRUTA C BURJI , Female , aged 21 years, SRF ID 2952700417147

Belgaum Institute of Medical Sciences BIMS Belgaum Karnataka NEGATIVE
2021-01-12 and tested for COVID19 at declared by the lab on .

Karnataka State War Room

Govt. of Karnataka

(This is digitally generated report and does not require physical signatures. You
can verify result using SRF ID at https://www.covidwar.karnataka.gov.in/service1 )