Surname:  ASIIMWE

Other names:  JONATHAN

Sex: MALE

Class: BABY CLASS

Date of birth:  19^TH/ 05/ 2017

Telephone No:  0759 522 709

Residential address:  SALAMA MUNYONYO

RECOMMENDER: I certify that the applicant is personally known to me and to the best o my knowledge and belief, facts stated on this form are correct. I am a citizen of Uganda.

Full names: NAKIBERU RASHIDAH

Address: Salaam                                                                Signature

BASIC AIDS ORGANISATION:

We as the organization we agreed with this information obtained here for any assistance rendered

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THANK YOU MAY GOD BLESS YOU