UNDER MATRIC MATRIC SR. SEC. GRADUATE P.G. SERVICE FARMER BUSINESS UNEMPLOYED CENTRAL GOVERMENT STATE GOVERNMENT 8 9 LOCAL NON LOCAL CATEGORY ST SC OBC OTHER 10 PERMANENT ADDRESS PRESENT ADDRESS a HOUSE NO.: HOUSE NO.: b STREET/ROAD: STREET/ROAD: c LOCALITY: LOCALITY: d P.O./P.S.: P.O./P.S.: e DISTRICT: DISTRICT: f CONSTITUENCY: CONSTITUENCY: g SUB-DIVISION: SUB-DIVISION: h GRAM PANCHAYAT: GRAM PANCHAYAT: REVENUE BLOCK: S.S.C. IDEN. CERTI. SER. CER. PARCHA SURRENDRED CERTIFICATE SCHOOL CERTIFICATE ELECTORAL CARD NO.: For Official Use: NEW CARD NO.: Checked Identified Approved
