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Acknowledgement Receipt

ëĠČćĉĊǿćĚ÷đȄĚƌěƸĜöĚĐĊǿ

Acknowledgement No. : Applied On : 26/03/2016


1. ĊĐěČĚĐĐNPR ĠöĚĂ : 180037059000200030300
(If available)

2. ĊĐěČĚĐĐĎĝ÷ȻŋĉĚĎ ĎĠĉĚĐĎĚĎėĚŽě
House/Plot No. : 58
āěöĄĚDzĚĊULB : WARDNO02

Block : NIMAPARA NAC


District : PURI
Mobile No : 7978822010

3. ĊĐěČĚĐĐĖćĖȻŋĖè÷ȻĚ 3

a) ĖćĖȻŋĉĚĎ :

ǰĉè ĉĚĎ ýĉȯąĚĐě÷ đěŏ Ďĝ÷ȻŋĖėĖƓöƽ ëĈĚĐĖè÷ȻĚ EPIC Ėè÷ȻĚ


1 ĎĠĉĚǐĎėĚŽě 04 Jan 1975 ĊĝĐĝĕ Son 525878070079
2 ĎĠĉĚĐĎĚĎėĚŽě 15 Jul 1936 ĊĝĐĝĕ Head 707295707413
3 ĐĚýěǟĎėĚŽě 05 Apr 1979 ĊĝĐĝĕ Son 900718819974

4. Ration size indicated


ĎĝŢĊěüĚČĚüědžČĚĖĚĎDzĜĐĊĐěĎĚĄ  : 4 Kg Rice & 1 Kg Wheat

5. FPS Name and Code (Preferred) ĊĖƃöĐĚďĚìdžČĚFPSĐĉĚĎôĠöĚǕ}


2613P018-JITENDRA KUMAR MISHRA 2613P018
6. Electricity Consumer No : 03498737 Electricity Division : Nimapada Electrical Division, Nimapada
(NED)
Distributor : CESU

7. LPG Gas Connection No : NA Gas Agency : NA


Distributor : NA

8. Auto Inclusion ȄďĝýȻ : No

9. Bank Account Number : 30077076670

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