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VENUE :
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DATE :
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TO
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| Cert. No. : Label
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That Mr./Mrs. .Label
. Father's ..Label
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DOB: ..Label
...From .Label
.. State Participated as a |
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Player/Official in .
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At.. .Label
.. in The Game ...Label
.. Event/Weight ..Label
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In Age Group ..Label
. and Got .Label
. Medal |
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