Key No. FORM No.

IV
M0491WB07012019001000 [See Rule 11(1)]
GOVERNMENT OF KERALA
DEPARTMENT OF PANCHAYATH
CERTIFICATE OF MARRIAGE
[ Issued under rule 11 (1) of the Kerala Registration of Marriages (Common) Rules, 2008 ]

Certificate No. 205/2019 Dated. 18/01/2019

This is to certify that the following information has been taken from the Register of Marriages (Common) maintained in Form No. III
in the Office of the Local Registrar of Palamel Grama Panchayat

1. Date of Marriage : 03/01/2019

2.Place of Marriage : St. Renatus Malankara Syrian Catholic Church

Palamel Village, Mavelikara Taluk, Alappuzha District

3. Details of Parties to the Marriage (as on the date of marriage)

Details Husband Wife

(a) Name in full (Capital Letters) RAVEEN ABRAHAM RAJAN VARSHA G MATHEW

(b) Nationality Indian Indian

(c) Age and date of birth 25, 04/02/1993 25, 22/10/1993

(d) Occupation Instrumentation Engineer Software Engineer

(e) Permanent Address s/o Abraham Rajan, 3, 47, Anaswara d/o George Mathew, 309, Kozhikunnathu
Sankarathil, Ulavakkad, Nooranad.PO, House, Kadammanitta, Kadammanitta.PO,
Alappuzha, Kerala - 690504 Pathanamthitta, Kerala - 689649

(e.a) where the husband is a Non - resident

Indian
(i) Address 16,3rd Floor, 197 Building, Street 20 Block 4
Mangaf, Kuwait

(ii) Security Number 274526051

(iii) Passport Number Z2879187

(f) Name of parents or guardian and the

relationship
(i) Father Abraham Rajan George Mathew

(ii) Mother Beena Rajan Sherly Mathew

(ii) Guardian

This certificate is computer generated and does not require any Seal/Signature in original.
The Govt. vide G.O.(P) 6/2013/Law Dated 09/10/2013 has approved this certificate as a valid document for all official purposes
The authenticity of this certificate can be verified at www.cr.lsgkerala.gov.in. The Key Number is unique to each event.
Software developed and supported by Information Kerala Mission.
Certificate printed before the last updated date is invalid
Page 1/2
Key No.
M0491WB07012019001000
3. Details of Parties to the Marriage (as on the date of marriage)

Details Husband Wife

(g) Photographs:

Registration No. 12/2019 Date of Registration : 16/01/2019

Date of Issue : 18/01/2019 (15:44)

: Eighteenth Day of January 2019

Last Updated on 16/01/2019 (18:01) Local Registrar : Local Registrar of Marriages (Common) ,
Palamel Grama Panchayat

This certificate is computer generated and does not require any Seal/Signature in original.
The Govt. vide G.O.(P) 6/2013/Law Dated 09/10/2013 has approved this certificate as a valid document for all official purposes
The authenticity of this certificate can be verified at www.cr.lsgkerala.gov.in. The Key Number is unique to each event.
Software developed and supported by Information Kerala Mission.
Certificate printed before the last updated date is invalid
Page 2/2