Government of Karnataka

Certificate of Registration of Hindu Marriage

FORM II-A
[See Rule 4(5)]
(Under the Hindu Marriage Act, 1955)
(Central Act, XXV of 1955)

This is to certify that Smt. Shobha Patil Daughter of Parappa Patil Residing at , patil Tot, Bagalkot,

Jamakhandi, Teradal Hobli, Chimmada, Karnataka-587312 and Sri Giramallappa Bheemappa Teli
Son of Bheemappa Teli Residing at No 1801/12, Mugalakhod, Belgaum, Raibagh, Kudachi Hobli,

Mugalakhod, Karnataka-591235 have furnished the particulars in memorandum declaring that their
marriage has been solemnised on 25-05-2022 and that the same has been registered on 28-05-2024 entered

as TRD-HM00139-2024-25

Signature of Marriage Officer

Digitally signed by SURESH MUTTAPPAGOL

Date: 2024.05.28 10:43:52 +05:30
Reason: Marriage Registration
Location: Teradal SR
Station : Teradal
Marriage Number : TRD-HM00139-2024-25
Date : 28-05-2024