Professional Documents
Culture Documents
Record “A”
Name TALEBAR SINGH Gender
:
SHIV DAYAL SINGH
Rln Name : RLN Type : F
DOB : Age : 40
Mobile No.:15/04/1981 Email Id : NA
+917798484963
286/1 Raj Nagar Bareilly
Street /
Area : Town
Post Office : Raj Nagar Pin Code : 403508
Record “B”
EPIC Gender Age RLN
Name Rln Name Address Photo
Number Type
SHIV DAYAL M 39
TALEBAAR SINGH
SES0380576 SINGH F 36/1,
Raj
Nagar
Elector A B
Fields
*Mark () / or (×) *Mark () / or (×)
Name
Age
Gender
Relation Type
Relation
Name
Photo Graph
Remarks
* - Individual fields will be cross verified with both persons “A” & “B” separately, even if A & B is a same individual.
This will give an idea about mistakes in the electoral roll.
Remarks
1. A is original & B is duplicate
2. B is original & A is duplicate
3. A & B Both are different persons
4. A & B both do not exist (A/S/D)
5. Others (Specify the reason __________________________________________)
Date:
Place:
Applicant's Signature/Thumb BLO Signature
Impression
Demographically similar entries
Record “A”
DOB : Age : 30
Mobile No.:15/04/1981
7798475646 Email Id : NA
Street /
544/2 Raj Nagar Bareilly
Area : Town
Post Office : Raj Nagar Pin Code : 403508
Record “B”
EPIC Gender Age RLN
Name Rln Name Address Photo
Number Type
Manmohan F 30
Saritaa
ISA3433156 F 336/1,
Raj
Nagar
Record “C”
EPIC Gender Age RLN
Name Rln Name Address Photo
Number Type
Elector A B C
Fields
*Mark () / or (×) *Mark () / or (×) *Mark () / or (×)
Name
Age
Gender
Relation Type
Relation
Name
Photo Graph
Remarks
* Individual fields will be cross verified with “A”, “B” &” C “separately, even if they are same individual. This will give an idea
about mistakes in the electoral roll.
Remarks
1. A is original & B & C are duplicate
2. B is original & A & C are duplicate
3. C is original & A & B are duplicate
4. A, B & C does not exist (A/S/D)
5. Others (Specify the reason __________________________________________)
Date:
Place:
Applicant's Signature/Thumb BLO Signature
Impression