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{1} p&r& nim {aTk p\Ym lKv)} :
{2} (pti/p(tn&> nim :
{3} jºmtir)K :
{4} ti. 27.08.2009 ni ri[j umr : vP<....................mis.............
(dvs............
{5} p#iÄyvhir miT[n&> srnim&> :
___________________________
{p)n ki[D n>br siY[} ___________________________
___________________________
{6} S]x(Nk liykit
an pis kr[l bi[D>/y&( pis l)F[li (vPyi[ m[Lv[l m[Lv
&. pr)xi nvs)<T) kyi<n&> g&Nni [l
n>. vP< Tki vg</k
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7

ni[>F:
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arJ siY[ sim[l riKv)
2. mitZBiPi (sviyn) Birtn) ki[e pN BiPin) (np*Nti Frivt) pr)xin) mi(ht)
upri[kt ki[lmmi> dSi<vv). t[mj t[ a>g[ni p\miNp#in) p\mi(Nt nkl arJ
siY[ sim[l riKv).
3. ki[À¼y&Trni ki[P</pr)xi pis kyi<n) mi(ht) upri[kt ki[lmmi> dSi<vv)
t[mj t[ a>g[ni p\miNp#in) p\mi(Nt nkl arJ siY[ sim[l riKv).
{7} lG&(l(pmi> kib[(lyt : a>g\[J/g&jrit) lG&l[Knmi
{fkt AT[ni[g\ifrn) j³yi ........................S.z.p\.(m.
miT[ni um[dviri[ miT[}
{8} Tiep)>gmi> kib[(lyt : a>g\[J Tiep......................S.z.p\.(m.
{fkt AT[ni[g\ifr an[ g&jrit) Tiep ...................S.z.p\.(m.
ai(sAT>T{j&.k.}n) j³yi
miT[ni um[dviri[ miT[}
{9} um[dvirn[ siekl clivti
aivD[ C[? {hi/ni}
{fkt b[l)fn) j³yini
um[dviri[ miT[}
{10} S&> arjdir an&s*(ct ji(t an&s&(ct jnji(t
/simiJk an[ S]x(Nk r)t[ pCitvg</ Sir)(rk
Ki[DKi>pN Frivnir/ miJ s](nk C[? ji[ ‘hi’
hi[y ti[ ji(t jNiv), ji(t a>g[ni p\miNp#in)
p\mi(Nt nkl arJ siY[ sim[l riKv).
{11} an&Bv, ji[ hi[y ti[.
{12} ai (jÃlin) adiltmi> tmiri ki[e sgi ni[kr)
kr[ C[? ji[ ‘hi’ ti[ t[mn&> nim, hi[Ñi[ tYi t[mn)
siY[n&> sgpN jNivv&>
{13} a#i[n) kc[r) Ùiri tir)K : 10.02.2005 ni
ri[j “g&jrit smicir” d](nk p#imi> p\(sÛ
Yy[l) jih[ritni an&s>Fin[ arJ kr[l C[ k[
k[m? {hi/ni}
AYL :
tir)K : -------------------------
{um[dvirn) p*r[p*r) sh)}
a[krir
aiY) h&> n)c[ sh) krnir um[dvir p\mi(Nt kr& C& k[, upr jNiv[l tmim
hk)kti[ miri jiNvi
tYi minvi p\miN[ s>p*N< sic) an[ Kr) C[. h&> smj&> C&> an[ s>mt Yiu
C&> k[, ki[e pN tbkk[ , ki[e
pN s>ji[gi[mi, ki[epN mi(h(t j[ m[ p*r) piD), t[ Ki[T), aF&r) aYvi
Kim)y&kt jNiS[ ti[ mir) arJ/um[dvir) rd Yvin[ pi#i qrS[,
an[ ji[ mn[ (nmN*>k aipvmi> aiv) hS[ ti[ mir) (nmN*>k rd krvi pi#i YS[.
AYL :
tir)K : ----------------------------
{um[dvirn) p*r[p*r) sh)}
arJ siY[ sim[l p\mi(Nt nkli[n) (vgt: