APPLICATION FORM FOR ADDITION / DELETION

Enp loyee Code 10159228

.NO.
OF CGHS IDENTITY CARD 4392086
2. NAME OF THE GOVT. SERVANT
PARIMAL SINHA
MINISTRY/OFFICE IN WHICH WORKING- OFFIce OF PosTMAS TER GENERAL,
DEPT. O F PoST , Miniskry o6 Counmunicahau f IT,

4. NEW ADDITION/DELETION

SI.no. Name
Date of Birth Relation

KUSHAGRA SINGH 27 07 2011 SO N.

SIGNATURE OF GOVT.
THUMB IMPRESSION.
SERVANT/

Date 20-1222.

6. SIGNATURE
ISSUING
AND DESIGNATION OF:
AUTHORITY / SEAL