A½xKvi bvgv
(cvm‡cvU© Gi Z_¨ cwieZ©b/ms‡kvab msµšÍ)
Bs‡iwR K¨vwcUvj †jUv‡i c~iYxq
Avwg ........................................................... wcZvt....................................................... gvZvt.........................................................
†ckvt...................................................... wVKvbvt........................................................ ag©t..............................
RvZxqZvt evsjv‡`kx, RvwZq cwiPq cÎ
b¤^vi/Rb¥ wbeÜb b¤^vi (AcÖvß eq¯‹‡`i †ÿ‡Î) .........................................GB g‡g© A½xKvi Kwi‡ZwQ †h, Avgvi cvm‡cvU© b¤^vi
......................., Bmy¨i ZvwiLt .........................., G Av‡e`‡bi mgq Avgvi wbR bvg/wcZvi bvg/ gvZvi
bvg/ Rb¥ ZvwiL fzj wjwce× Kiv nBqv‡Q| cÖK…Z c‡ÿ Avgvi RvZxq cwiPq cÎ/Rb¥ mb`
(AcÖvß eq¯‹‡`i †ÿ‡Î) Abyhqx Avgvi wbR bvg/wcZvi bvg/gvZvi bvg/Rb¥ ZvwiL Ges
cvm‡cv‡U© DwjøwLZ wbR bvg/wcZvi bvg/gvZvi bvg/ Rb¥ ZvwiL wb¤œiæct
|
eZ©gvb cvm‡cvU© cÖ`wk©Z fzj Z_¨
|
RvZxq cwiPqcÎ/ Rb¥ mb` Abyhvqx cÖK…Z Z_¨
|
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NAME
|
NAME
|
|
FATHER’S
NAME
|
FATHER’S
NAME
|
|
MATHER’S
NAME
|
MATHER’S
NAME
|
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SPOUSE’S
NAME
|
SPOUSE’S
NAME
|
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DATE
OF BIRTH
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DATE
OF BIRTH
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PLACE
OF BIRTH
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PLACE
OF BIRTH
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OTHER,S
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OTHER,S
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VILL:
P.O:
P.S:
DS:
|
VILL:
P.O:
P.S:
DS:
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Dchy©³ A½xKvibvgvi hveZxq Z_¨ mwVK fv‡e Bnvi
†Kv‡bv Ask wg_¨v b‡n| Avwg †Kvb Z_¨ †Mvcb Kwi bvB| †Kvb wg_¨v Z_¨ w`qv _vwK‡j
GB cwieZ©b/ms‡kvabRwbZ Kvi‡b fwel¨‡Z †Kvb cÖKvi AvBbMZ RwUjZv nB‡j Avwg `vqx
_vwKe|
Avwg †¯^”Qvq I ¯^Áv‡b Dch©³ A½xKvibvgvi hveZxq
gg© mg¨K AeMZ nBqv ¯^vÿi cÖ`vb Kwijvg|
(¯^vÿi/ Awfeve‡Ki ¯^vÿi (Av‡e`bKvix AcÖvß
eq¯‹ nB‡j)
|
