nvg``© cvewjK K‡jR

(K‡jR †KvW: 1170; EIIN: 134209)

151/8, MÖxb †ivW, cvš’c_ (cvš’c_ wmMb¨vj), XvKv 1205|

A¨vmvBb‡g›U I
wkÿv_©xi Z_¨
g~j¨vqb
1| wkÿv_©xi bvg : ---------------------------------------------------------------------------------------------------------

2| †kÖwY : GKv`k
3| †ivj bs :
4| †mKkb : --------------------------------------------------

5| wefvM : weÁvb
6| †gvevBj b¤^i : wbR: -------------------------------------------- evev/gv/AwfeveK:
--------------------------------------------

A¨vmvBb‡g‡›Ui Z_¨
7| welq I A¨vmvBb‡g›U bs : ------------------------------------------------------------------------------------------------

8| A¨vmvBb‡g‡›Ui wk‡ivbvg :
------------------------------------------------------------------------------------------------

9| welq wkÿ‡Ki bvg : K………….-------------------------------------- L.

--------------------------------------

M. -------------------------------------- N. --------------------------------------
O. --------------------------------------

10| Mªnb I Rgv`v‡bi ZvwiL : Mªnb: ------------------------------ Rgv`vb: -----------------------

 g~j¨vqb
AwZ DËg DËg fv‡jv AMÖMwZ
cÖ‡qvRb
 ----------------------------
welq wkÿ‡Ki ¯^vÿi I
ZvwiL

nvg``© cvewjK K‡jR

(K‡jR †KvW: 1170; EIIN: 134209)
151/8, MÖxb †ivW, cvš’c_ (cvš’c_ wmMb¨vj), XvKv 1205|

A¨vmvBb‡g›U I
wkÿv_©xi Z_¨
g~j¨vqb
1| wkÿv_©xi bvg : ---------------------------------------------------------------------------------------------------------

2| †kÖwY : GKv`k
3| †ivj bs :
4| †mKkb : --------------------------------------------------

5| wefvM : e¨emvq wkÿv

6| †gvevBj b¤^i : wbR: -------------------------------------------- evev/gv/AwfeveK:
--------------------------------------------

A¨vmvBb‡g‡›Ui Z_¨
7| welq I A¨vmvBb‡g›U bs : ------------------------------------------------------------------------------------------------

8| A¨vmvBb‡g‡›Ui wk‡ivbvg :
------------------------------------------------------------------------------------------------

9| welq wkÿ‡Ki bvg : K………….-------------------------------------- L.

--------------------------------------

M. -------------------------------------- N. --------------------------------------
O. --------------------------------------

10| Mªnb I Rgv`v‡bi ZvwiL : Mªnb: ------------------------------ Rgv`vb: -----------------------

 g~j¨vqb
 AwZ DËg DËg fv‡jv AMÖMwZ
cÖ‡qvRb

----------------------------
welq wkÿ‡Ki ¯^vÿi I
ZvwiL