Add New Complaint Details

“_ͧž€ȡ™€ȡͪšŽ‡Ȫ°Ʌ

1. Complaint No.
ͧž€ȡ™ Ȳ District
ǔ‡›ȡ›“a

Police Station
ȡ“ȡ¡ “‚Ȳ‡ Date of Complaint
ͧž€ȡ™€ȧǑ‘“ȡȲ€

2. Details of the complainant

ͧž€ȡ™€ȡ[€ȡͪšŽ

a) Nature of Complaint
ͧž€ȡ™€ȡĤ€ǙǓ‡“ͪšȪ’Ȣ

b) UID No.
™Ǘ]_ŒȢ Ȳ

c) Name
“ȡ˜Nabeel Husain d) Father's/Husband's Name
ͪ”ȡ”Ǔ€ȡ“ȡ˜

e) Landline No.
›ɇŒ›ȡ^“ Ȳ f) Mobile No.
˜Ȫ–ȡ^› Ȳ

g) Age
]™Ǖ h) Date of Birth
‡Û˜Ǔͬ

i) Email ID
_˜ȯ›]_ŒȢnabeelhusain77@gmail.com j) Country of Nationality
šȡçĚȣ™ȡ¡ȯǕ‘ȯž

k) Address
”ȡ

S.No. Address Type

”ȡ€ȡĤ€ȡš Address
”ȡ

Đ Ȳ
1 [˜ȡ“”ȡ 538A/009A,trivani nagar 3rd,lucknow,›“a`׏šĤ‘ȯž—ȡš
2 [˜ȡ“”ȡ 538A/009A,trivani nagar 3rd,lucknow,›“a`׏šĤ‘ȯž—ȡš

3. Identification Details of the complainant

ͧž€ȡ™€ȡ[€ȡ”¡…ȡ“ͪšŽ

S.No.
Đ Ȳ Identification Type
”¡…ȡ“Ĥ€ȡš Identification No.
”¡…ȡ“ Ȳ

4. Details of the Accused

\ͧ—™Ǖȏ€ȡͪšŽ

a) UID No.
™Ǘ]_ŒȢ Ȳ b) Name of Accused
\ͧ—™Ǖȏ€ȡ“ȡ˜

c) Mobile No.
˜Ȫ–ȡ^› Ȳ

d) Landline No.
›ɇŒ›ȡ^“ Ȳ

e) Address
”ȡ

S.No. Address Type

”ȡ Address
”ȡ

Đ Ȳ
€ȡĤ€ȡš

5. Incident Details
ƒŠ“ȡ€ȡͪšŽ

a) Place of Incident
ƒŠ“ȡ€ȡèȡ“Kursi Road, Dasauli, Uttar Pradesh, Lucknow District 226021

b) Type of Incident
ƒŠ“ȡ€ȡĤ€ȡšloss of identity card

c) Is Date/time of incident known

șȡƒŠ“ȡ€ȧǑ‘“ȡȲ€ ˜™£ȡ¡Ȱ!“¡ȣȲ

d) Uploaded Document
\”›ȪŒͩ€f‚f‘èȡȯ‡

S. No.
Đ Ȳ File Name
¹ȡ^›€ȡ“ȡ˜ Description
ͪšŽ
1

e) Date & Time of Incident From

ƒŠ“ȡ€ȧǑ‘“ȡȲ€kš ˜™ ȯ

f) Date & Time of Incident To

ƒŠ“ȡ€ȧǑ‘“ȡȲ€kš ˜™€

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6. Complaint Details
ͧž€ȡ™ͪšŽ

a) Date of Complaint
ͧž€ȡ™€ȧǑ‘“ȡȲ€

b) Uploaded Document
\”›ȪŒͩ€f‚f‘èȡȯ‡

S. No.
Đ Ȳ File Name
¹ȡ^›€ȡ“ȡ˜ Description
ͪšŽ
1

c) Mode of Receipt
Ĥȡǔ܏€ȧͪͬ’

d) Remarks
ǑŠÜ”ͨŽ™ȡȱ

e) Complaint Description
ͧž€ȡ™ͪšŽ
I lost my identity card of institution of engineers (India) in the integral university central canteen where i was eating my dinner.

Report Printed on
ǐš”ȪŠ[˜ǕġŽ€ȧǑ‘“ȡȲ€–‡ȯ Signature
¡èȡ¢š

Report Printed by
ǔ‡ €ȯɮȡšȡǐš”ȪŠ[˜ǕǑġ Name
“ȡ˜Nabeel Husain

Rank
”‘

No.
 Ȳ

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