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MARRIAGE REGISTRATION CERTIFICATE

) Form No.: A
(See Rule 4 Hindu Marriage Registration)

1. Regd. No.
2. Date of Application
3. Name and Present Address of
Husband J A G A N M A Y A PANY
S/o: Kahnu Charan Pany
At: Saraberani, PO: Sanda,
Dist-Dhenakanal, State: Odi^
Wife D E E P A N J A L I PANDA
W/o: Jaganmaya Pany
At: Saraberani, PO: Sanda, PS:1
Dist-Dhenakanal, State: Odisha-
Date and place of Marriage Date: 24.02.2019
At: Panchapada, PO: Panchapada, PS: Rasol,
Dist-Dhenkanal, State: Odisha

\
Date of Birth
Husband 28-04-1988

\
Wife 02-07-1991
5. Name & Present Address of the Guardians of the parties Marriage
Son Kahnu Charan Pany
At: Saraberani, PO: Sanda, PS:Parjang
Dist-Dhenakanal, State: Odisha- 759019
Daughter Trilochan Panda
At: Panchapada, PO: Panchapada, PS: Rasol,
Dist-Dhenkanal, State: Odisha

6.
Name & Address of the witnesses
(A) Manas Ranjan Pany, At: Saraberani, PO: Sanda, PS:Parjang, Dist: Dhenkanal, State: Odisha
(B) Purnananda Pany At: Saraberani, PO: Sanda, PS:Parjang, Dist: Dhenkanal, State: Odisha

7. Remark The marriage has been registered on under

Hindu marriage registration rule-1955.

Registrar, Hindu Marriage-cum-Addl. Ppjj^X^

Parjang Block, Dist-DhenkF*-

Memo No.
Issued to the Applicant as applied

Registrar, Hindu Marnag^cum-A&il. B.D.O.

Parjang Block, ^gfoJ^jfiiphanal

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AUTHENTIC/

Dr. Santosh Ba»a

Special Secretary
Home Department
OevL of Odisha
Bhubaneawar (INDIA)