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West Bengal e-District Application Form

Uploaded by

Manish Das
Copyright
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0% found this document useful (0 votes)
29 views2 pages

West Bengal e-District Application Form

Uploaded by

Manish Das
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Applicant Details

Salutation First Name Middle Name Last Name


Mr. Manish Kumar Das
Date Of Birth Age Gender Date of Application
26-DECEMBER-1997 26 Male 3-OCTOBER-2024
Mobile Number Email Aadhaar Pan
8981201725 mkdjeet8@[Link] 322213487310 CPUPD7936R

Applicant Present Address

Country State District Sub Division


India West Bengal North 24 Parganas Barrackpur
Block/Municipality/Municipal Block/Municipality/Municipal
Rural or Urban Village Ward
Corporation Corporation Name
U 22
M Kamarhati (Municipality)
Address Line 1

.0
1/1 B, Haripada Mukherjee
Police Station Post Office Address Line 2
Street, P.O/P.S-Belgharia,
Belghoria Belgharia HO
t2North 24 Parganas, West
NA

Bengal-700056
Pincode
ic
700056
tr

Applicant Permanent Address


is

Same Address As Country State District


Present Address India West Bengal North 24 Parganas
D

Block/Municipality/Municipal Block/Municipality/Municipal
Sub Division Rural or Urban
e-

Corporation Corporation Name


Barrackpur U
M Kamarhati (Municipality)
Address Line 1
1/1 B, Haripada Mukherjee
Village Ward Police Station Post Office
Street, P.O/P.S-Belgharia,
22 Belghoria Belgharia HO
North 24 Parganas, West
Bengal-700056
Address Line 2 Pincode
NA 700056

Minor/Student and Special Case Details

Applicant is Minor/Student Special case


YES Not Applicable

Family/Guardian Details

Relationship Salutation First Name Middle Name Last Name

Generated on : 2024-10-03T[Link].226

P & AR Department,Government of West Bengal. All rights reserved. | Site Hosted By Webel Technology Limited (WTL). |Designed,developed,and
maintained by TATA Consultancy Services Ltd.
Version ID: 1.0 Beta | Site best viewed on Chrome/Firefox/Edge, on a 16:9 aspect ratio screen
Father Mr. Mantu Kumar Das

Mother Mrs. Anita Das

Income Details

Annual Income(Only for old


Monthly Income Business Details Reason for Application
application data)
16000 Student Other
NA
Other Reason
Scholarship

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t2
ic
tr
is
D
e-

Generated on : 2024-10-03T[Link].268

P & AR Department,Government of West Bengal. All rights reserved. | Site Hosted By Webel Technology Limited (WTL). |Designed,developed,and
maintained by TATA Consultancy Services Ltd.
Version ID: 1.0 Beta | Site best viewed on Chrome/Firefox/Edge, on a 16:9 aspect ratio screen

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