Surname: NABAKIIBI
Other names: PATRICIA
Sex: FEMALE
Class: PRIMARY TWO
Date of birth: 13/11/2011
Telephone No: 0782 88 50 93
Residential address: SALAAMA ROAD
RECOMMENDER: I certify that the applicant is personally known to me and to the best of my knowledge and belief, facts stated on this form are correct. I am a citizen of Uganda.
Full names: KASANDE CHRISTINE
Address: SALAMA ROAD signature …………………………………….
BASIC AIDS ORGANISATION
We as the organization we agreed with this information obtained here for any assistance rendered
……………………………………………………………………………….
………………………………………………………………………………..
THANK YOU MAY GOD BLESS YOU