Passport Application Government of India, Ministry of External Affairs Online Application Receipt Applicant Details : Applicatio 12-2392568 n Reference

No Service FRESH Type Type of Normal Applicatio n Applicatio 25/03/2012 n Submitted Date Date of 01/10/1950 Birth Gender MALE Employme NOT EMPLOYED nt Type Marital MARRIED Status Place of JAFRABAD Birth JALALPUR Applicant FATIMA KHATOON Name Father's ABDUL HASAN Name Mother's UMME KULSOOM Name

Spouse's MUKHTAR HUSAIN Name Present 89/2 JAFRABAD JALALPUR AMBEDKAR NAGAR - 224149 Address UTTAR PRADESH , INDIA Applicants References : First FARYAD HUSAIN-JAFRABAD JALALPUR AMBEDKAR NAGAR , 9452270345 Reference Details Second MOHAMMAD SHOEB-JAFRABAD JALALPUR AMBEDKAR NAGAR , 9807002658 Reference Details Appointment Details : LUCKNOW , RATAN SQUARE, 20-A, PSK VIDHAN SABHA Location MARG, LUCKNOW226001 Date & Time of 29/03/2012 & Appointment 02:45:00 PM 1000013139409 Appointment ID 12 Reporting Time 02:15:00 PM

Note: Applicant should reach the Passport Seva Kendra by the reporting time mentioned above for pre-checking of documents to avoid any hassles in issuance of token. Applicant will not be issued token at Passport Seva Kendra, if they report after scheduled appointment time. Carrying of corrosive substances or explosives, arms or any sharp objects which may cause physical harm or violence are prohibited inside the PSK. Electronic items such as Laptop, iPad and cameras are also prohibited inside the PSK.