FORM B





Certificate of Age



See Rule 17 (2)



Certificate No………………………



I hereby certify that I have personally examined (name………………………………

Son\ daughter of………………………residing at……………...and…………… …………

That he/she completed his\her fourteenth year and his\her age, as nearly as can be pertained from my examination, is years (completed).

His/her descriptive marks are………………………………………………………………

Thumb impression/signature of child………………………………………………………

Place……………………………………. Medical Authority

Designation.

Date…………………………………………