Learner'S Licence: Chokrantakath Chapparapadava Po Kooveri Taliparamba Mo 7593060569,670581

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FORM 3

[See Rule 3(a) and 13]

LEARNER'S LICENCE

1386220021
Application No...................................

Learner's Licence KL86 /0006607/2021 13-04-2021


Issue Date......................

1. Name : MUJADDIR

2. Father's Name MUSTHAFA MADATHIL

3. Date of Birth : 26-02-2003

4. Blood Group(Optional) : O+ Spicemen signature/ thumb impression of


the holder of the of the
CHOKRANTAKATH CHAPPARAPADAVA PO Kooveri TALIPARAMBA MO
5. Present Address/ 7593060569,670581
Permanent Address :

CHOKRANTAKATH CHAPPARAPADAVA PO Kooveri TALIPARAMBA MO


6. Temporary/Official(if 7593060569,670581

Marks of Identification : 1.
7.
2.

is licenced to drive throughout India as a learner subject to the provisions of rule 3 of


the Central Motor Vehicles Rules 1989, a motor vehicle of the following description
MCWG, LMV,

*The holder of the licence has passed the medical test under rule 5 and the preliminary

*The holder of the licence is exempted from medical test under rule 6 and from the
preliminary test under rule 11(2) of the Central Motor Vehicles Rules, 1989.
This Licence is valid from : 13/04/2021 To 12/10/2021

* Strike off whichever is inapplicable

Signature of the Licencing authority


SRTO PAYYANNUR
Warning: The attention of the holder of this licence is drawn to rule 3 of Central Motor vehicle Rules, 1989
which prohibits him from driving any motor vehicle unless he has besides him a person duly licenced to drive the
vehicle and in every case , the vehicle carries "L" plates both in front and in the rear of the vehicle.
DL Test Schedule
Sl.No Class of Vehicle Date and Time Venue

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