--'a

ri-'"
il
]I
*S."*
-]A-L
L-:r.i

qqa
11" 1 {iiq'leil r{6T{ 5
F0tLNl-5
N0. r
',.rr i ril'ri|\I OI' ll.\RYAN \
:: ;:)^-i iliil :', .;IPARTT{INT OF HF-ALTH S:P.VICIS 6d's-"%
, .';1:r nr':661 q6fra
U'- ",ti,€
rl
. i, i, iii,il,il'.\I NARNr\I,l

.I
;t--+{ s]{Iui-g;r
| ilr'rr{ cF,RIlflCAlE

:i:, i;,: 1., ::';2, i.rii :i ; r-',t;4;;8;t'-,

?rr / sEX, {ris / MALE

q;; Ilrq/ 1'1.^Acl": oF lliR'lH:

CI,]- I]05PII'AL, NARNAUL
r,r rr :.\\\l) l llli'i 'i:i
. ii / i.; '.r'f- r-ri; iiOTHIRI 'i: : - ;' ;t / NAlv{E o1r IrAI'LIi,lll:
;::': ,:, ;
)\....; ,, FA'II-1ER'T.i AADIIAAII N(]:

(.iiJNi: ',- , '. \ \R\.{LL, M,\HE\Ditia,.'i'l:i.

H\111 \\'r
(1\4;r1 7;i119 i t)A'tr otr Iircls't'RA'l'r\)i'J.
12"05-20i8

ii . :' t;; -, ,;1-1- '; ::1 . - / lSstll\(l ,\lliFll.rRl i''r' r

ll
'7ri-')t;.'Jti I I

I.rl ii l ) r^r ii
l , [, ]0i)t 00 0fr'i)0

' u{[ rlf)\"i Oi:tirl)tAVii)ii r.lit]i,1.^ll NO i/1?/2014-VSlCr{SiDAfilD',17-Jtil,Y-20151'{,\S

,1i,pRtl\/LtD t'i{lS CL.il ilFICA'tL .r,\ i\ r'{t.tT1 I tiriAl., nOCUI!{]jNr ]'oll Ai.t, OFI'ltllAi- FUnPOSES'.

" u(+,!;idrin'qsq?{qtf ".rd1qi{qgF.tr1i,.rd v,i' z rrsr nr:xHGI.irR\r'lo\(}t}:\'I':R}ttIRTll.tNl}I}tl"c.'l'lt"

I

I
I li I i$:iiErlHlilBliElEilif llEillllEi!lllElllHl lH
j