Form ‘A’

uequk ^v*

pkfj«; ¼orZ.kwd½ izek.ki=

Áekf.kr dj.;kr ;srs dh] Jh@Jherh@dqekjh

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gs@g;k--------------------------------------------------------------------------------------------]
rkyqdk------------------------] ftYgk-------------------------] ;sFkhy jfgoklh vlwu]
eh R;kauk ekxhy ---------------- o"kkZiklwu vksG[krks] R;kaph orZ.kwd o pkfj«;
pkaxys vkgs- rs@R;k ek>s@ekÖ;k ukrsokbZd ukghr-

dfjrk lnjhy orZ.kwd@pkfj«; izek.ki= ns.;kr ;sr vkgss-

fnukad%&-------------------- izek.ki= ns.kkÚ;kps uko] gqÌk o lgh

fBdk.k%&------------------- lgh --------------------------------------------

uko --------------------------------------------
gqÌk ---------------------------------------------
iRrk ----------------------------------------------
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Hkze.k/ouh Øekad ------------------------------