GOVERNMENT OF ANDHRA PRADESH

REVENUE DEPARTMENT

Application No

CGC240508024339
Date : 08/05/2024

COMMUNITY , NATIVITY & DATE OF BIRTH CERTIFICATE

1. This is to certify that the Sri/Srimathi/Kumari PADMASHALI RAGHU MADHU MOHAN S/o / D/o / M/o / F/o / W/o
/ H/o / C/o Sri. P NARAYANA of B.THANDRAPADU village / Town of Kurnool Rural Mandal of KURNOOL District
of the State Andhra Pradesh belongs to Padmasali (Sali, Salivan, Pattusali, Senapathulu, Thogata Sali) (BC-B)
Community / Caste which is recognized as Backward Class under i) G.O.Ms NO.1793, Education, dt.23.09.1970 as
amended from time to time.

2. It is certified that the Sri/Srimathi/Kumari PADMASHALI RAGHU MADHU MOHAN is a native of CIVIC 49,
KADAMBARI TOWNSHIP Locality/Landmark of B.THANDRAPADU village / Town of Kurnool Rural Mandal of
KURNOOL District of the State Andhra Pradesh.

3. It is certified that the place of Birth Sri/Srimathi/Kumari PADMASHALI RAGHU MADHU MOHAN is of
B.THANDRAPADU village / Town of Kurnool Rural Mandal of KURNOOL District of the State Andhra Pradesh.

4. It is certified that the Date of Birth Sri/Srimathi/Kumari PADMASHALI RAGHU MADHU MOHAN is 01 Day June
Month 1983 Year (in words) Zero One - June - One Nine Eight Three as per the declaration given by his/her
Father/Mother/Guardian and as entered in the School records where he/she studied.

Certified By

Name : B RAMANJULA NAIK

Designation : Tahsildar
Mandal : Mandal : Kurnool Rural

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