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/2021/001938

Certified that below mentioned candidate

Name : Hitesh Babulal Patel
Father Name : Babulal
Resident of : 13, Ganesh Park 2, R.C.Technical Road, Ghatlodia, Ahmedabad.,
Ghatlodia, Ahmedabad City West, Ahmedabad, Gujarat - 380061
ǁŚŽƐĞററƉŚŽƚŽŐƌĂƉŚററĂƉƉĞĂƌററŽŶററƚŚĞററƌŝŐŚƚററĐŽƌŶĞƌററŽĨററƚŚĞററĐĞƌƚŝĨŝĐĂƚĞ͕ററŚĂƐററďĞĞŶററĞŶƌŽůůĞĚററĂƐററ&ŝƌĞററ^ĂĨĞƚLJററKĨĨŝĐĞƌററŝŶററ
ƚŚĞറĐĂƚĞŐŽƌLJററററ&^KററററͲററററ^W/>/^dററററĨŽƌററററƚŚĞററററƐƚĂƚĞററററƵŶĚĞƌററററ^ĞĐƚŝŽŶററററϭϮറററŽĨറററdŚĞറററ'ƵũĂƌĂƚറററ&ŝƌĞറററWƌĞǀĞŶƚŝŽŶറററĂŶĚറററ
>ŝĨĞറററ^ĂĨĞƚLJDĞĂƐƵƌĞƐറററ;ŵĞŶĚŵĞŶƚͿററĐƚ͕ററϮϬϮϭററററĨŽƌററĂററƉĞƌŝŽĚററŽĨററƚŚƌĞĞററ;ϯͿററLJĞĂƌƐററĨƌŽŵററƚŚĞററĚĂƚĞററŽĨററĞŶƌŽůŵĞŶƚററ
ĂŶĚററǀĞƐƚĞĚററǁŝƚŚƚŚĞƉŽǁĞƌƐĂŶĚƌĞƐƉŽŶƐŝďŝůŝƚŝĞƐŐŝǀĞŶƵŶĚĞƌƚŚĞĐƚĂŶĚƚŚĞZƵůĞƐ͘

/ŶറററƚŚĞറററĞǀĞŶƚറററŽĨറററĂŶLJററĐŽŵƉůĂŝŶററŽƌററĨŽƌററĂŶLJററŽƚŚĞƌററƌĞĂƐŽŶƐററƌĞĐŽƌĚĞĚററŝŶററǁƌŝƚŝŶŐ͕ററƚŚĞററŝƌĞĐƚŽƌററŵĂLJററĐĂŶĐĞůററƚŚĞററ
ĞŶƌŽůŵĞŶƚററĂŶĚƚĂŬĞĂĐƚŝŽŶƵŶĚĞƌƚŚĞĐƚĂŶĚƚŚĞZƵůĞƐ͘

Place : Gandhinagar
Date of Enrolment : 16 Dec 2021

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

Date & Time: 16/12/2021 3:14:06 PM

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