Òcwiwkó-MÓ

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Dc‡Rjv K…wl Awdmvi
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fvovq †mev cÖ`v‡bi Rb¨ GKwU K…wl hš¿ Dbœqb mnvqZv g~‡j¨ µ‡q
AvMÖnx|

ewY©Z hš¿wU µ‡qi Rb¨ g~j¨ †_‡K wba©vwiZ Dbœqb mnvqZv Ask ev`
w`‡q Aewkó A_© bM` cÖ`v‡b Avwg cÖ¯‘Z AvwQ|

AZGe Avgv‡K ewY©Z h‡š¿i wecix‡Z miKvwi Dbœqb mnvqZv

cÖ`v‡bi cÖ‡qvRbxq e¨e¯’v MÖn‡Yi Rb¨ Aby‡iva Rvbvw”Q|

1| h‡š¿i bvg :..................................................................................................

2| eª¨vÛ :..................................................................................................
3| g‡Wj :..................................................................................................
4| ZvwjKvfz³ cÖwZôv‡bi
bvg :...............................................................................

Av‡e`bKvix
µ: Av‡e`bKvixi wcZvi bvg RvZxq cwiPq wVKvbv Av‡e`bKv
bs bvg I †gvevBj cÎ bs/Dbœqb MÖvg BDwb Dc‡Rjv ixi ¯^vÿi
bs mnvqZv qb ev
KvW© bs wUcmwn