FORM 3
[See Rule 3(a) and 13]
LEARNER'S LICENCE
4427303121
Application No...................................
Learner's Licence KL18 /0020277/2021 23-12-2021
Issue Date......................
1. Name : ASMEERA
2. Father's Name MOOSA
3. Date of Birth : 18-02-1999
4. Blood Group(Optional) : O+ Spicemen signature/ thumb impression of
the holder of the of the
CHANDHAMKANDIYIL HO KATAMERI PO VILLIAPPALLY VIA,673542
5. Present Address/
Permanent Address :
CHANDHAMKANDIYIL HO KATAMERI PO VILLIAPPALLY VIA,673542
6. Temporary/Official(if
Marks of Identification : 1. MOLE BELOW THE ARM
7.
2. MOLE ON THE RIGHT CHEEK
is licenced to drive throughout India as a learner subject to the provisions of rule 3 of
the Central Motor Vehicles Rules 1989, a motor vehicle of the following description
LMV, MCWOG,
*The holder of the licence has passed the medical test under rule 5 and the preliminary
*The holder of the licence is exempted from medical test under rule 6 and from the
preliminary test under rule 11(2) of the Central Motor Vehicles Rules, 1989.
This Licence is valid from : 23/12/2021 To 22/06/2022
* Strike off whichever is inapplicable
Signature of the Licencing authority
Warning: The attention of the holder of this licence is drawn to rule 3 of Central Motor vehicle Rules, 1989
which prohibits him from driving any motor vehicle unless he has besides him a person duly licenced to drive the
vehicle and in every case , the vehicle carries "L" plates both in front and in the rear of the vehicle.
DL Test Schedule
Sl.No Class of Vehicle Date and Time Venue