Surname:   LUBEGA

Other names:  GABREILLA

Sex:   FEMALE

Class; BABY

Date of birth:  5/6/2016

Telephone No:  077945781

Residential address:   SALAMA

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

Full name: NABALE FARIDA

Address:  SALAMA                                                                    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