FORM F. L. XI
[See rule 72]
Licence No.
Licence for the possession and use of brandy and rum, by industrial, educational, scientific, research or such other institution or by a pilot of an air-craft or by a person in charge of an ambulance or a first-aid station, for rendering first-aid or for medicinal purpose in an emergency.
Licence is hereby granted under and subject to the provisions of the Bombay Prohibition Act, 1949 (Bom. XXV of 1949), and the rules, regulations and orders made there under to Shri/Smt./Kumari of (herein after referred to as "the licensee",) on payment of a licence fee of Rs authorising him/her to purchase, transport, possess and use brandy and rum, for rendering first aid or for medicinal purpose in an emergency during the period from to at (herein after referred to as "the licensed premises") or at any other place within the 1State of Maharashtra1 where the ambulance/air-craft in charge of the licensee may proceed, subject to the following conditions namely.