Surname:  MUNTUSINI

Other names:  SUUNA

Sex:  MALE

Class: BABY CLASS

Date of birth: 03/05/2017

Telephone No: O704 95 2661

Residential address:  MASAJJA

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: KIMBUGWE MUNDA SHIRU

Address: MASAJJA                                                                   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