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Al Lener ) 2. Enrolment No. and date 3. Office Address 4. Residential Address 5. Phone Nos. (I) Office: (2)Residence: (3)Mobile: 6. Blood Group 7. Details of Prescribed fee: (a) D.o. 1 PayOrder No. . & dated ( DDlPay Order of Rs. 350/-) (b) Drawn on bank drawn in favour of 'The Registrar (Admn.), Supreme Court oflndia payable at New Delhi) I Certify that the above particulars are correct. I undertake to intimate and to surrender the proximity card when I stop practice, during the vali.

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