Bhubaneswar Municipal Corporation

Application Form for Marriage Registration

Date of Marriage (dd/mm/yyyy) :

Place of Marriage :

Bridegroom’s Name :

Bridegroom’s Guardian’s Name :

Bridegroom’s Address :

Bridegroom’s Date of Birth (dd/mm/yyyy) :

Relation of Guardian with Bridegroom :

Bride’s Name :

Bride’s Guardian Name :

Bride’s Address :

Bride’s Date of Birth (dd/mm/yyyy) :

Relation of Guardian with Bride :

Priest Name :

Priest Address :

First Witness Name :

First Witness Address :

Second Witness Name :

Second Witness Address :

Signature of Bridegroom

Signature of Bride