A½xKvibvgv

(cvm‡cvU© Gi Z_¨ cwieZ©b/ms‡kvab msµvšÍ)

Avwg ...................................... wcZv:...................................

gvZv:............................
wVKvbv:......................................................... †ckv:.......................
ag©:............................... RvZxqZv: evsjv‡`kx, RvZxq cwiPqcÎ b¤^i/ Rb¥
wbeÜb (AcÖvß eq¯‹‡`i †ÿ‡Î) ................................. GB g‡g© A½xKvi
Kwi‡ZwQ †h, Avgvi cvm‡cvU© b¤^i.............................. Bm¨yi
ZvwiL: ...................... G Av‡e`‡bi mgq Avgvi wbR bvg/wcZvi bvg/gvZvi
bvg/Rb¥ ZvwiL fzj wjwce× Kiv nBqv‡Q| cÖK…Zc‡ÿ Avgvi RvZxq
cwiPqcÎ/Rb¥ mb` (AcÖvß eq¯‹‡`i ‡ÿ‡Î) Abyhvqx Avgvi wbR bvg/ wcZvi bvg/
gvZvi bvg/ Rb¥ ZvwiL Ges cvm‡cv‡U© D‡jøwLZ wbR bvg/ wcZvi bvg/
gvZvi bvg/ Rb¥ ZvwiL wb¤œiƒct

eZ©gvb cvm‡cv‡U© cÖ`wk©Z fzj RvZxq cwiPqcÎ/Rb¥ mb` Abyhvqx

Z_¨ cÖK…Z Z_¨
bvg: bvg:
wcZvi bvg: wcZvi bvg:
gvZvi bvg: gvZvi bvg:
Rb¥ ZvwiL: Rb¥ ZvwiL:

Dch©y³ A½xKvibvgvi hveZxq Z_¨ mwVK| Bnvi †Kvb Ask wg_¨v b‡n|
Avwg †Kvb Z_¨ †Mvcb Kwi bvB| †Kvb wg_¨v Z_¨ w`qv _vwK‡j GB
cwieZ©b/ms‡kvabRwbZ Kvi‡Y fwel¨‡Z †Kvb cÖKvi AvBbMZ RwUjZv nB‡j
Avwg `vqx _vwKe|

Avwg †¯^”Qvq I ¯^Áv‡b Dch©y³ A½xKvibvgvi hveZxq gg© mg¨K

AeMZ nBqv ¯^vÿi cÖ`vb Kwijvg|
¯^vÿi/Awffve‡Ki ¯^vÿi (Av‡e`bKvix AcÖvß eq¯‹ nB‡j)