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XvKv Kgvm© K‡jR

XvKv Kgvm© K‡jR †ivW, wgicyi, XvKv-1216

A¨vmvBb‡g›U

wel‡qi bvg I cÎ: ....................................................................................

A¨vmvBb‡g‡›Ui
µg mßvn cÖ`v‡bi ZvwiL Rgv`v‡bi ZvwiL

A¨vmvBb‡g‡›Ui wk‡ivbvg:

wkÿv_©xi bvg:.............................................................................................

‡ivj bs:.................................... †mKkb/MÖæc:.............................................

wkÿv_©xi mvÿi:........................... Awffve‡Ki mvÿi:.....................................

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wkÿ‡Ki g~j¨vqb:
AwZ DËg DËg fv‡jv AMÖMwZ cÖ‡qvRb

cÖvß †¯‹vi:..................

g~j¨vqbKvix wkÿ‡Ki ¯^vÿi I ZvwiL:............................................................

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