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n‡e|
(Borrower’s Card- Gi Rb¨ Av‡e`b cÎ)

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[¯^ ¯^ Abyl‡` (√) wUK wPý w`‡Z n‡e ]
†K›`ªxq MÖš’vMv‡i e¨env‡ii Rb¨
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QvÎ/QvÎxi bvg : ........................................................................... wefvM :................................................
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¯’vbxq †hvMv‡hv‡Mi wVKvbv: ........................................................................................................................
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Awffve‡Ki bvg, wVKvbv, m¤úK© I †dvb b¤^i: ................................................................................................
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MÖš’vMv‡ii hveZxq wbqgvejx †g‡b Pj‡Z eva¨ _vK‡ev|
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QvÎ/QvÎxi ¯^vÿi
(Kv‡W©I GKB ¯^vÿi e¨envi Ki‡Z n‡e)
wefvMxq †Pqvig¨vb KZ©„K cÖZ¨qb

Av‡e`bKvix Avgvi wefv‡Mi ............................................................................................ †kÖwYi QvÎ/QvÎx Zvi

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[AbyMÖn K‡i wefvMxq †Pqvig¨vb †Kvm© †kl nIqvi m¤¢ve¨ ZvwiL GLv‡b wjL‡eb]
KvW© Bmy¨ Kiv n‡jv|
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MÖš’vMvi Kg©Pvixi ¯^vÿi MÖš’vMvi Kg©KZ©vi ¯^vÿi
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QvÎ/QvÎxi ¯^vÿi
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