Registration

State*

District*

Block*

GP/MC/NP*

Ward no*

Name of Applicant*

Father's Name*

Mother's Name*

Date Of Birth*

Contact Number*

Whatsapp Number*

Email ID*

Aadhaar Number*

Permanent Address

Name of Village / Town*

Post Office*

Police Station*

Pin Code*

Present Address

Name of Village / Town*

Post Office*

Police Station*

Pin Code*

Upload Final Marksheets

Madhyamik/Secendary*

Other Qualification

*

*

*

* File extension must be jpg, jpeg, gif, png, pdf, doc, docx