†ivj b¤^i:
RbZv e¨vsK wjwg‡UW
110, gwZwSj ev/G, XvKv-1000|
cÖvK PvKzwi e„ËvšÍ hvPvB dig
cÖv_©x †h c‡` wbhy³ nB‡eb †mB c‡`i bvg:
(e¨vsK KZ„©K c~i Y Kiv nB‡e)
cÖ_g fvM: (cÖv_©x wb‡R c~iY Kwi‡eb)
01| cÖv_©xi cyiv bvg (WvK bvgmn ¯úóvÿ‡i):
02| wcZvi cyiv bvg I PvKzwi‡Z _vwK‡j c‡`i bvg I
RvZxqZv:
03| gvZvi bvg:
04| RvZxqZv:
05| RvZxq cwiPqcÎ b¤^i (NID)/Rb¥ wbeÜb b¤^i:
06| ¯’vqx wVKvbv:
(Av‡e`bc‡Îi mwnZ mvgÄm¨ ivwLqv)
07| eZ©gvb evm¯’v‡bi wVKvbv:
08| cÖv_©x †hB mKj ¯’v‡b weMZ cuvP erm‡i Qq gv‡mi AwaK mgq Ae¯’vb Kwiqv‡Qb †mB mKj ¯’v‡bi wVKvbv:
wVKvbv ZvwiL nB‡Z ZvwiL ch©šÍ
09| Rb¥ ZvwiL (gva¨wgK ¯‹zj mvwU©wd‡KU/mggv‡bi cixÿvi mvwU©wd‡KU Abyhvqx):
10| Rb¥¯’vb (MÖvg, †cv÷ Awdm, _vbv/Dc‡Rjv, †Rjv BZ¨vw` D‡jøL Kwi‡Z nB‡e):
11| cÖv_©x c‡b‡iv ermi eqm nB‡Z †hB mKj we`¨vjq, gnvwe`¨vjq I wek¦we`¨vj‡q Aa¨qb Kwiqv‡Qb †mB mKj wkÿv
cÖwZôv‡bi bvg I ermi D‡jøLc~e©K wkÿvMZ †hvM¨Zv:
we`¨vjq, gnvwe`¨vjq, wek¦we`¨vjq GmGmwm/GBPGmwm/ cÖvß wefvM/ fwZ©i ZvwiL/ cwiZ¨v‡Mi
BZ¨vw`i bvg Abvm©/gv÷vm© wWwMÖi †kÖwY/wRwcG/ ermi/†mkb ZvwiL/ermi
†iwRt b¤^i/†ivj b¤^i wmwRwcG
cvZv b¤^i- 1/4
†ivj b¤^i:
12| †Kv‡bv miKvwi/Avav miKvwi/¯^vqËkvwmZ/¯’vbxq miKv‡ii ms¯’vmn †emiKvwi cÖwZôv‡b cÖv_©x c~‡e© PvKzwi Kwiqv
_vwK‡j/eZ©gv‡b Kg©iZ _vwK‡j Dnvi c~Y© weeiY I wVKvbv Ges †mB¸wj cwiZ¨v‡Mi KviY:
wb‡qvMKvix Awdm/e¨emv ZvwiL nB‡Z ZvwiL ch©šÍ Kg©iZ _vwK‡j cwiZ¨vM Kwi‡j
cÖwZôv‡bi bvg (Kg©iZ wjwL‡Z nB‡e) (cwiZ¨v‡Mi KviY)
evsjv‡`k †mbvevwnbxi Aax‡b cÖv_©x c~‡e© PvKzwi Kwiqv _vwK‡j Ae¨vnwZ mvwU©wd‡KU wjwce× PvKzwii †gqv`, Kx Kx `vwqZ¡
cvjb Kwiqv‡Qb Ges PvKzwi I AvPvi-e¨envi m¤úwK©Z wi‡cv‡U©i mswkøó weeiYv`x D‡jøL Kwi‡Z nB‡e|
13| cÖv_©x gyw³‡hv×vi cyÎ/Kb¨v/cyÎ Kb¨vi cyÎ Kb¨v wKbv (nuv/bv): -----------------------------------------|
● cÖv_©x gyw³‡hv×v A_ev knx` gyw³‡hv×vi cyÎ Kb¨v/cyÎ Kb¨vi cyÎ Kb¨v nB‡j †mB g‡g© Dchy³ KZ…©cÿ KZ…©K cÖ`Ë
wcZv/gvZv/wcZvg‡ni gyw³‡hv×vi mvwU©wd‡KU Gi mZ¨vwqZ Kwc Ges
● cyÎ Kb¨vi cyÎ Kb¨v nB‡j cÖgvY¯^iƒc mswkøó BDwbqb cwil‡`i †Pqvig¨vb/wmwU K‡c©v‡ik‡bi IqvW© KvDwÝji/†cŠimfvi
†gqi/KvDwÝji KZ…©K cÖ`Ë mvwU©wd‡KU Rgv w`‡Z nB‡e|
14| cÖv_©x cªwZeÜx wKbv (nu¨v/bv): ----------------------------|
(cÖwZeÜx †KvUvi cÖv_©x nB‡j mswkøó KZ…©cÿ KZ…©K cÖ`Ë cÖwZeÜx mb‡`i mZ¨vwqZ Kwc ms‡M w`‡Z nB‡e|
UxKv: mswkøó wb‡qvMKvix KZ„©c‡ÿi mš‘ó nB‡Z nB‡e †h, DwjøwLZ f~Zc~e© mvgwiK Kg©Pvix‡`i Ae¨vnwZ mvwU©wd‡KU Ges
gyw³‡hv×vi I cÖwZeÜxi `vwLjK…Z mvwU©wd‡KU m‡šÍvlRbK|
15| †dŠR`vix, ivR‰bwZK ev Ab¨ †Kv‡bv gvgjvq †MÖdZvi, Awdhy³ ev `wÛZ Ges bRie›`x ev ewn¯‹vi nBqv‡Qb wKbv,
nBqv _vwK‡j ZvwiLmn c~Y© weeiY w`‡Z nB‡e:
16| wbKU AvZœxq-¯^R‡bi †Kn A_©vr fvB-fwMœ, Avcb PvPv, k¦ï‡ii w`‡K wbKU AvZœxq-¯^Rb evsjv‡`k miKv‡ii PvKzwi‡Z
wbhy³ _vwK‡j, c‡`i bvg I Kg©¯’j D‡jøLc~e©K c~Y© weeiY:
AvZœxq-¯^R‡bi bvg c‡`i bvg Kg©¯’j
cvZv b¤^i- 2/4
†ivj b¤^i:
17| cÖv_©xi PwiÎ I c~Y© cwiPq m¤ú‡K© mvÿ¨ w`‡Z cv‡ib wKš‘ cÖv_©xi mwnZ AvZœxq m~‡Î Ave× b‡nb Ggb `yB Rb MY¨gvb¨
e¨w³i wVKvbvmn bvg:
bvg wVKvbv
18| weevwnZ ev AweevwnZ (weevwnZ nB‡j ev weev‡ni cÖ¯Íve _vwK‡j hvnv‡K weevn Kiv nBqv‡Q ev weevn Kivi cÖ¯Íve
iwnqv‡Q Zvnvi RvZxqZv D‡jøL Kwi‡Z nB‡e):
Avwg kc_c~e©K ewj‡ZwQ †h, Dc‡i cÖ`Ë weeiYmg~n Avgvi Rvbvg‡Z mwVK| wg_¨v Z‡_¨i Rb¨ cÖvw_©Zv/cixÿv evwZjmn
Avgvi weiæ‡× Ab¨vb¨ e¨e¯’v †bIqv hvB‡Z cv‡i|
---------------------------
cÖv_©xi ¯^vÿi I ZvwiL
ম োবোইল নম্বর:
†cÖiYKvix Awdmv‡ii ¯^vÿi I c`ex
Ges cyiv wVKvbvmn Awd‡mi bvg I ZvwiL
cvZv b¤^i- 3/4
†ivj b¤^i:
wØZxq fvM:
(†Rjv †¯úkvj cywjk mycvwib‡Ub‡W›U/evsjv‡`k †¯úkvj eªv‡Âi †WcywU B݇c±i †Rbv‡ij Ae cywjk c~iY Kwi‡eb|)
Dchy³
wb‡¤œv³ Kvi‡Yi Rb¨ Abychy³:
¯’vb: ----------------------------
ZvwiL: --------------------------
----------------------------------------
cywjk mycvwib‡Ub‡W›U, †Rjv †¯úkvj eªvÂ/
†WcywU B݇c±i †Rbv‡ij Ae cywjk,
†¯úkvj eªvÂ, evsjv‡`k|
UxKv: cÖZ¨q‡b mswkøó cÖv_©xi weiæ‡× †Kv‡bv wKQz bv cvIqv †M‡j †Rjv †¯úkvj eªv‡Âi cywjk mycvwib‡Ub‡W›U evsjv‡`k
†¯úkvj ev‡Âi †WcywU B݇c±i †Rbv‡ij Ae cywjk Revemn GB digwU †cÖiYKvix KZ…©c‡ÿi wbKU mivmwi †diZ
cvVvB‡eb|
wKš‘ hw` mswkøó cÖv_©xi weiæ‡× †iK‡W© †Kv‡bv Z_¨ cvIqv hvq Zvnv nB‡j †Rjv †¯úkvj eªv‡Âi cywjk mycvwib‡Ub‡W›U
evsjv‡`k †¯úkvj eªv‡Âi GwWkbvj B݇c±i †Rbv‡ij Ae cywj‡ki gva¨‡g Revemn GB digwU †cÖiYKvix KZ„©c‡ÿi
wbKU †diZ cvVvB‡eb|
cÖwZ¯^vÿwiZ -------------------------------
G¨vwWkbvj B݇c±i †Rbv‡ij Ae cywjk
†¯úkvj eªvÂ, evsjv‡`k|
cvZv b¤^i- 4/4
