PERSONAL INFORMATION :-

* Application Number

* Registration Date

* Full Name

 

* Email ID

* Mobile Number

* WhatsApp Number

 

* Voter ID Number

 

* Date Of Birth

 

*Age

 

* Gender

 

* Category

 

* Sub Category

 

* Annual Income

 

* Profession

 

* Other Profession Type

 

* Marital Status

 

* Blood Group

 

* Are you only single women?

 

* Are you Physically Handicapped?

 

* Enter Percentage of Physically Disability

 

* Do you own a house at MC Mandi?

 

* Accommodation Type

 

* Are you Senior Citizen?

 
PERMANENT ADDRESS :-

* Village/House No.

 

* Ward Name/No.

 

* Panchayat

 

* Post Office

 

* State

 

* District

 

* Tehsil

 

* Pin Code

 
CORRESPONDANCE ADDRESS :-
 If same as Permanent

Village/House No.

 

Panchayat

 

Post Office

 

State

 

District

 

Tehsil

 

Pin Code

 
 I declare that all statements and particulars contained in this citizen enrollment form required to be presented with this citizen enrollment form, are complete, exact and true to the best of my knowledge.
State/National Awards :-

* Name of Award/Certificate

 

* Type

 

*Detail