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AUTHORIZATION FORM FOR OPENING DSPT SUBSCRIBER AT SIKANDARABAD HUB

SDCA: Phidngia
SSA r Phulbhani
CIRCLE: Odhisa
0

6?l

I/SAT

ID '

Category (USGvFr/vPr-MHA,/comnerciayservi. etc) VPI-MHA

If NEW/Change in Custodian/ Shifted from: NEW


Date of Physical Inrtallation: Installed by SDE(NW-OP-CFA) PHULBANI
Custodian Details
THE COMII'IANDANT 1278N CRPF
Father's

Name

I THE COMMANDANI 127BN CRPF(B/127 CRPF)

Landndrl: polise
Complete Address

s!a_ti_or_89qhha!_a_d_a_

_ _ _

__ ____ __

_ _

_V_rl_lite:_Q9c_[\aI_ad."

!_o_s!QJtqejG_qcErrlsda__B_lac_kJ_T_d*e_P_hJr_i!'g_4

,Disfieti(!a4dhar!_qL _SIAIE

9!j!h4

Any Other Informalion phutbhani SSA

BSNL Contact Details


(sTD- CODE)Telephone No.
Nearcst Exch

MobiIe

S,K]ENA

lTO,Phulbani

068.t2-256000

9437562207

MA]H]

SDE.Phulbani

06842-254000

94171614M 06842253
I soo

lncharge

sDo /DE

SSA.DSPT

FAX

Number

SB

06842-27300

SDE USO ,phulbhani

9437967n7

F-neil ID

06842253
900

hi@gmail.com

068{2253900

PKROY

A O(TRA),Phulbani

06812-255800

941787666

Offi.er (TR)

06842253900

SSA Head/

TDE Phulbhani

B Behe.a

06842-2531 00

9437233000

DCM incharge

06842-

b.behera@bsnl.

253q)0

Ref No./Adv. Note

No.

Date:

Routed No.100:

101:

Fax (05735-244401) to: DE (DSPT) S

l02l
local complain:
, with authoization to allow outgoing facility on above

TELEPHONE N0-05735-

Date

lnstaller

Copy To (1)

-------TO

Phulbani-762!')

BE

(2\

Local in-charge

()
SSA

Coordinator/Stamp

(3)

fILLED UP at Sikandarabad DSPT HUB

Customer Account Nurrrber:

-,----------------------9M

Date

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