Ration Card Member Member Addition (Birth) Application Form Form [PDF]

3 downloads 126 Views Report
Member Addition Details. Member. Name. Mother Name. DOB. (dd/mm. /yyyy). Gender. Informant Details. Applicant Name/ House Head Name*: Informant ...
Conversion of White Card to Pink Card Conversion of White Card to Pink Card

Ration Card Member Addition (Birth) Application Form Request Details Ration Card No*:____________________________________ ____________________________________

Member Addition Details Member Name

Mother Name

DOB (dd/mm /yyyy)

Gender

Age

Father Name

Spouse Name

EID

UID

Informant Details Applicant Name/ House Head Name*::______________________________________ Informant Name*:________________________________________________________ ________________________________________________________ Informant Relation*:______________________________________________________ ______________________________________________________ Mobile No*:____________________________________________________________ ____________________________________________________________ Delivery Type*:  Manual Proof Document*:  Affidavit  Birth Certificate  CGHS Card

Documents List (NOTE: 1. All Upload Documents should be in PDF Format only 2. Each file ile should not exceed 50KB) 1.

Application Form*

2.

Proof Document*

3.

Photo*(JPG or JPEG format only)

Applicant’s Signature

Relation with Head