Format-A

For Visit of Aadhaar Enrollment Centre/EMitra

1. Name of the Centre :-

Add:…………………………………………….Tehsil: ……………. District ………........

2. eMitra ID (for centre working at EMitra):-

3. Name of E.A.:…………………… Contact no of EAs SPOC (Ask from Operator):………

4. Whether under State Registrar/Non State Registrar :-

5. Operator Details

Name:………………………… Certificate no:……………………. Mob no:………………….

Machine Codes of Kit:-………………………………

Is Machine provided free from RISL (Y/N):--

Is operator is Supervisor (Yes/No):

6. Inspection Details :-

a. Whether a Aadhaar & Bhamashah Registration is free is displayed Yes/No

(if No, Give Observations)

b. Whether Rate List is displayed Y/N

(if No, Give Observations)

c. Overall Functioning based on

i. capturing details of mobile number from resident (yes/No)

ii. Whether GPS device is installed (yes/No)
iii. Inquire from 4-5 people (residents who have already availed services) regarding
function of the centre (on complaint/overcharging issue etc)
7. Details of any Issue (as raised by Operator or VLE of E-Mitra):-
…………………………………………………………………………………………………..

8. Any other observations :-

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Date of Inspection:-
Time :- Signature of Inspecting officer
Name & Designation of Inspecting Officer:-
 Format-B

Fortnightly summary of the field visits

District

Date of Centre Block Ward/GP/ LSP/EA eMitra ID, Operator Is operator Is Kit Is Aadhaar Is Rate Any additional
Visit Name Village name If centre is mob no a provided & List Observation/Issue
at eMitra Supervisor Free from Bhamashah displayed
(Y/N) RISL (Y/N) Free (Y/N)
Displayed
(Y/N)

<ACP Signature>

<ACP Name >

Analyst-Cum-Programmer (Dy Director)
<Date>