Old Food Licensce

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Registration / eocks {See Reguiation 2-1.1(5)) (Beat 2.1115) 9 tera) d q Government of Kernataka Soars ears Registration under FSS Act,2006 SPOT ST crab, sen OOaS Reccd Reglstration No / staoties xxl, : 21 4. Name and address of applicant: Serer sed mw oes 19380000597 RANGANATHA. P. 0 / KARANM FAMILY RESTAURAN (NO-721, HEROHALLT CROSS, MAGADAI MAIN nom SESIMANTHAPURA, BANGALORE. Yeshwanthonen’ 8.8.6.2 North (Karnataka), - se009% 2 Address of location where food business is to S722, HEROHALLE CROSS, MaADst Hain ROAD be conducted Premises: BE UWANTHAPURA, BANGALORE., Yeshwanthe sen Od mad nibs WV/endeS ova: 8.BM.P North (karnataka), - S600: 3. Kind of Food Business : Food vending establishment Sysrce oo: : wurants 4. Photo Identity Card (Detaite) : act ccterieh Sek ct (oes Aschear cars the pay eae sericae is issued under and is subfectad to {5c provision of FSS Act, 2006 all of Ie DEL food business/ ok gees BSaeF ore, Beh, 200eKa.g Sep Aeosstevid easnonaic, which must be co 2 Siebocd ounce wey ae Place /qv: Date'y Bxret:08/03/2019 Validation and Renewe! O68 ti) ssoeds ; fgnature ot] eel Petiod of Renewal(eep | Hems of food Manutacturea [Signature of] persica Date) oh Registration ree pala handied | Registering | w=] sonstatewns oan, | “mctaten fee | esseaaecr td anneyaee| Meee ; = es | ee Seoty xb | Please refer to annexure for _detaiis, 8/93/2019 4 Year(s) a £07/03/2020) Pets / 90)

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