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Sari atone 8 1B /OtsHOS TO mabdg, seseehes ae sonesdt Agrees sairdact mdonQ sad aeojsbed saxon BonscDod Bgelt Sar don Bmadedom Tancesoxeans. sheen CES Ae £8 bgp SOHO shoadarmgnods %& egeook atau she domed Banoo ae Doe:28 Bmrdd Ee Hos: neve 44 A8D 2001 Gmro¥: 27.07.2001 Sebas -3 aeuxinecr AMEIMG HIbOwN aBBe owas arty =8/; By BeBe aye 2g RWOQH Tang mNAdS ws : aad evowcists eaioonsonnd, a Estos exodar, oleesamen —____ sainobo mprdatarkeyennd oom e sheet gaededond — (©) ** mAmE Gd soy wn) ecloomeONY, wa Ea Bedvod Graal, (e) * + odnendii Bader Ramodm, Sroded: oleewdoned wx) mada me: (a) # * way EHOONSONG Bm YA Semod vPraay eAm engos wad gx Bam: (8) 9+ aed amagicie audrey clarudood AAs, ae: BBR Omer: maghideoob seach29 Age old, male / female, Registration No sssea He / She is physically % . cevnse is. a.case of - - disabled/visual disabled/speech & hearing disabled and has .. Gs sosee--pereent) permanent (physical impairment visual impairment speech & hearing impairment) in relation to his / her Note: 1. This condition is progressive/non-progressive/likely to improve/not likely to improve. * 2, Resasvessinent is not recommended/is recommended after a period of. + Strike out which is not applicable . months!years. * (Recent Attested Photograph showing the disability affixed here) Orthopedic /Senior Specialist Chairperson Districtye / ENT / Psychiatrist Member, Medical Surgeon District, ‘Member, Medical Board District Hospital Board Signature / Thumb impression of the disabled personx 30 GOVERNMENT OF KARNATAKA DEPARTMENT 0} Office of the Deputy Director, Department of Sainik Welfare & Resettlement (Kamataka) No, Date: CERTIFICATE This is to certify that Sri /Smt/Kum is an applicant for is the Spouse / Son / Daughter of No, Rank Name of Army / Navy / Air Foree, who is an Ex-Serviceman according to the definition laid down by the Minister of Defence, Govemment of India. He served from to The Ex-Serviceman had declared his home town in Karnataka at the time of entry into service as per records & hence eligible to avail reserved seats under Ex-Serviceman quota, His permanent home address at the time of entry into service was as under: Signature of the Deputy Director Department of Sainik Welfare & Resettlement District OR yee x Bor; seen aages. coorsaa CERTIFICATE fe This is certify that Sri / Smt / Kum is am y ey, applicant for is the Spouse / Son / Daughter of No. Rank Name > = who Died / Disabled while in service according to the certificate issued by Defence Authority. He Died / Disabled on Home address of the individual at the time of joining Defence Service as per the records is: BS Place: Signature of the Deputy Director Date: ‘Department of Sainik Welfare & Resettlement District sooty Soe etiger. abods32 aDN OANUS wes riQsachss uxperivo Kexdes mpROMeCH aidobeleoedd Roegteiree / emebs agp dabad ‘Onvot: AMER / Vas By, Bors RACH. .. eiodg smoke / doremvomen mobradrbagey, addobad xoas; shomeutdes/ Hed este /637/2021-22, Oav0vi25-01-2022 eormetdados show, sey ASRS wD ompea Home LA 2. Regents asm SEARDS Boh eee axe “Gh xoq / Genetobod Grade eden aORog. spbs kembmes mpmoriy ricimecd saw are, 5 Adrensny abotdy Bow eigen. soa33 dad daw dy, Be _ gad abrimeyabrins br/aeabs _ aside, we SC Bortri¢od ng aba Sarl Sect mit mene Sommsgo styl Bged BagomgONARRS se Amro welgeif Aces edarAoehsos cle Xpapregervay, wait Beongsorm Bamedesonmges, BePesds _ ask Hat NowoGedy. ye t es: fmn08: wothagrimas :