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Government of Karnataka

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Government of Karnataka: Department of Labour

Ward/ Hobli/ Construction Site name and Address:

Sl. Name of the person to whom Mobile No. BOCW Registration Number Nature of Work Signature of the Ramarks
No the food grain box is / Aadhar Number / Any Person
distributed other Documents

Name and Designation of the food Signature: 1.______ 2._ 3. ___

grain distribution of Incharge staff

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