oÍl+sÏeÎBug ¡Ñsh 9l‰ e¡s‰ Î eÐs q}¾k uÀ‰s+s h}klls hs¹}ÐÍB '‰ƒ ...

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oÍl+sÏeÎBug ¡Ñsh 9l‰ e¡s‰ Î eÐs q}¾k uÀ‰s+s h}klls hs¹}ÐÍB '‰ƒ ...

oÍl+sÏeÎBug¡Ñsh9l‰e¡s‰ÎeÐs

q}¾k

uÀ‰s+sh}kllshs¹}ÐÍB‘‰ƒ¢Ks

gÓsd so+st¢Ks

¢ÑÓhuÀ‰s+s¢x‰ uÀ‰s+s

Ât¢t‘}ihs/Îgs˜hsB

nss¢ÑÂBÀ Ot

________________ÂB}

________________nss


OthsÐosq}Â

qÍB‘h}‘} e ¹BÂÐso3ÎÐtd}e+ssl}iq}gÍhs¹}Zs______________‘B }

Z¢tÎs __________________________________________ÐÍB Àt‰s+s h}wklls

‘‰ƒ ZBºB ‰t‘}ºt‘}g}ÐteZ‰tul¡g¢s»BºB¢s»t‘}ºt‘}


Àt‰s+sÐq}gÍB ‰ hZs

___________________ _________________________

___________________ _________________________

¡ ___________________ _________________________

À ___________________ _________________________

iZs_________________________


oshs/Îhsqtgtfé

‘‰e s‰ÐÍBÐsh ”h‰l–Ï u¢gs¢ugÐÍBÐsh

______________ _________ ______________

______________ _________ ______________

______________ _________ ______________

‰q}¾s+sÐÍBo‰ÐshÍBfé

¡sh___________ ¢9¹‘¼to__________ gsiÍ _____________

ue6i___________


¡ ¹BÂÐsl»sÐÍBÐsh______________________________________

¹BÂÐso3ÎÐtoB$Îsf______¢Í$gf______o¡t‰f______

¹BÂÐtqsiÐtlsu–Ï ‘sl Zs____________

À ‘‰e s‰‘ÐÍoÍudg×ugÐsº} }‘ÐÍoÍudgeÐ×ugÐsº}"

qsÐsul¡g‘s¢

d ‘‰e s‰ÐsÐs}»!guohsBg}»!g}gheA‰¡Ñs4Î s‰t¡‰‘/ÎhsBÓt Îsl¡Ïк}

g}e+ssl

º ‘‰e s‰}g}g}hÐs ¹BÂÐs‘/Î o3Î}oB uig¡Ñshul so sÎϘhq}¾k

‘¡sêuÀ‰s+sh}kl}iº}"qsÐs×}qsgÐtd}Ðtul¡g‘s¢


˜h

Àt‰s+si}Ðs‰

isÃsÓDÐÍBÐsh

Àt‰s+sÐ

q}gÍB

h}kl}i

oÂot»t

‰ hZs

h}kl}i

Àt‰s+s

‰ hZs

qsiÐtÂs t¢»gt

Àt‰s+sÐt‰ h

Zs




e}»s+sehtÐÐtul¡gf

‘‰e s‰Ðt¢gsÐthsit tÐtehtÐf


iul9gs‰‘B ‰é¡ÍB¾s

¡sh ol}ÏÐB uÂÐu¢Îg u¢Îg i ehtÐ

hq}oÍi

Zs

________ ________ ________ ________ ________ ________

________ ________ ________ ________ ________ ________

________ ________ ________ ________ ________ ________

________ ________ ________ ________ ________ ________


^¢_}Ãs»}h}kwl}iehtÐ

iul9gs‰‘B ‰é¡ÍB¾s

¡sh ol}ÏÐB uÂÐu¢Îg u¢Îg i ehtÐ

hq}oÍi

Zs

________ ________ ________ ________ ________ ________

________ ________ ________ ________ ________ ________

________ ________ ________ ________ ________ ________

________ ________ ________ ________ ________ ________


¹‘‰e s‰Ðthsit tÐs¢nÍosÀÐé‘׉Ðtul¡g‘‰ƒ ÎsÏÐtgs‰t}f


¢nÍosÀБ׉ÐÍBÐsh

Âk }gths¹}Ðs×Ðl‰ ____________ ____________

ÍÀsks×Ðl‰ ____________ ____________

‘ i‘}/ƒÐ¢B¢o}¹ i}¹¬t h¹‰ ____________ ____________

l¡}‰}

‘/Î9¢:¹ ‰ ____________ ____________


¾‘‰e s‰ ¹BÂÐsÂs t }lsÀt‰s+s×}qÎgg}‘B¡}Ðtul¡g‘‰e ÎsÏÐtgs‰t}


Âs t s‰ÐÍBÐsh

Àt‰s+sÐq}gÍ

uÀ‰s+s‘s¢Ðs‰

oB9ÓsÐÍBÐsh

Âs t‰ h

Zs

g}¢| thÍ g

ltgtÂs t‰ h

Zs

________________________________________________________

________________________________________________________

________________________________________________________

________________________________________________________


› ¢ÑsÓuh zu– hB»kt ehtÐ ul so Â}v o‰ s‰t Сslt lsu+s)Î Â}v ¢Ñs }un

¡Ñsuh+sÂ}v Ðs¡‰t Â}v ‘/ÎoB9Ós9¢:¹e+ssllt




qÍB‘h}‘sÓt×q}‰ ZBºB ‰t‘}ºt‘} }ꢉe+ssl}itul¡ghs‰t‘hs‰t×+s

‘Ð}hs/ÎgshÍeÂoB¢x+sÏosdt‘Ð}‰tº}qÍB‘h}‰s)ÎÐsloÍisghs¹} ‰}it

×}¡ls ‘Ð}oBhgºÍBºt‘}


gs‰tf ‘‰e s‰Ðtoqt


gsiÍ sul so‘uÀ s‰tOtue6is¡Ñshul so‘}e/otÐtÃish+s

‘sÓt qÍB ¢Ñhs+s¢Ks ‘s¢ÍB ºB } ꢉ#g ‘‰e s‰ ¹BÂÐs }»!gothsBg }»!g uÂÐ

}g‰ heA‰¡Ñs4Î he‰ g‰t } Ð\t ÓÎ}i º} ‘Ð} Ât¢t‘}i Îs t hÍe g}hÐ hs/Îgs

˜hsB ___________ º} g}hÐt ‘‰ƒ hsB e+ssl}i Àt‰s+sÐt ‰ h hBeA‰ ‰ls Ãish+s

‘sl}º}¢ÑÓhËtgtÎgÂ\shsB‘suÀ‰s+s‘/lÎ}g}‘Zs____________Ðt oqsÎÐ}

¢sKsº}‘‰e s‰‘‰e s‰ ¢+soq s‰t&st‰s+soB9ÓsÐshÍ gltgtÂs t s‰ÐÓt


gs‰t


gsiÍ sul so‘uÀ s‰tÐtoqt

gsiÍ ____________

ue6i____________


Àt‰s+sÐt‘‰ƒd so+stfé

gsiÍ sul so‘uÀ s‰tg‰¼Ót‘‰ƒh


Àt‰s+sÉ¢s loÍisg‘B¡}Ãish+sfé


hso_______________ÓtÀt‰s+sloÍisgÐs¢ÑÓhq0gsÐtnZ‘sg ‰t ‰}

q0gsÐt ‰ h Zs____________hÍe i__________________ q0gshsB hsuo

uKshsuo ºhsmo lsu–Ï q0gsÓt Àt‰s+sÐt loÍisg ‰lt ‘Ð} º}6i q0g Âs t ‰q}gt

‰ hZs __________________ÐloÍii}l‘}ltÃish+sº}


^7ÎseÐ ‰fé


¹‘l}euo#Ήt¹t ¢ÑsÓuh

lÀ s‰sÐt×}qÎgf


»‘/În‰gf






»




½

Ãs‰gtΉt^lÏÂ}v ‰s:¹¬tÎ zu–gÓs¡Ñs4Îul soÂ}v Ës‰sÐ\tÓÎ}iuÐÎh

hÍeÂ7ÎseÐ ‰‘} hÐtu RhgloÍisgÐsBnZ‘sgÐul‰shºA¹ÐohÎgÓs

loÍisgÐohÎl¡}‰}Бhi ‰lshsB‘sl}º} } }hqsÐs


d so+st ‰Ðs‰‘uÀ s‰tÐtoqt

ꢉhÍeÂÐtn‰ghÍeÂuÀ‰s+shBeA‰ ‰lshsB‘sl}º}

‘Óls

ÐshBeA‰ ‰lshsB‘sl}º}uÀ‰s+sÐt‰ h&s¹s»lshsB‘sl}º}

uÀ‰s+sÐshBeA‰ ‰lshsB‘sl}‘¡‰uÀ‰s+sÐt‰ hhsB&s¹s» ‰lshsB‘sl}gg}Ðs

s‰+s‘qÄe+ssl




gs‰t nss¢ÑÂBÀ Ðtoqt

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