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~2 1 I Date of Birth
10 /0 4/ 19 79 F
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CUMBUMMETTU,KERALA
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COCHIN
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ANNAMMA

BENOY CHACKO

ELAVUMPOIKAYIL HOUSE,VELLAYAMKUDY P.O

VELLAYAMKUDY,IDUKKI

PIN :68 551 5,K ERA LA ,IN DIA

C07 064 633 458 322