You are on page 1of 1

DETAILS OF FAMILY (FOR FAMILY PENSION) IN DUPLICATE AS DEFINED IN

RULE 7(1)(e)(2) OF D.C.R.B.RULE 1971


Rule 7(1)(e)(2) of D.C.R.B. Rules1971.

Sl No. Name of the Family Member(s) Relation Date of Birth

1 kamakhya charan bhattacharjee Father

2 mira bhattacharjee Mother

3 sanjit kumar maitra Spouse

Date : _____________________

Signature of the Applicant


DIPTI BHATTACHARJEE
(1985002608)
Health Assistant (Female)

Countersigned

OFFICE OF THE BMOH, KALIAGANJ


HAT PARA KUNUR, HAT PARA, KUNUR, Kaliaganj,
Uttar Dinajpur, West Bengal,Pin - 733129

15/09/2020 Page 1 of 1

You might also like