Ration Card and Member Personal details
RC Application No :-
N15035928460
Member ID :-
01
Personal & professional details
Member name (LL)
Member name (EN)
Spouse’s Name (LL)
Spouse’s Name (EN)
Father’s Name (LL)
Father’s Name (EN)
Mother’s Name (LL)
Mother’s Name (EN)
Gender
Relationship with head
Age (Yrs)
Date of Birth
(dd/mm/yyyy)
Mobile No.
Nationality
Ration Lifting Elgibilty
Yes, I have UIDAI/Aadhar No.
No, I Don't have UIDAI/Aadhar No., but I have enrolment no.
UID No.
eg. (1234/5678/9123)
Occupation details
Occupation
Total Annual income(in Rs.)
Birth Certificate
Document Type
--Select--
Birth Certificate (issued by competent authority, Municipality/ Office of Registrar Birth and death
High School Marksheet
Others
Pan Card
Voter ID card
Document Number
Document Issue Date
MNREGA
Mnrega Status
--Select--
Yes
No
Critical Illness
Are you suffering from any Critical Illness ?
Yes
No
Caste Category
Caste Category
--Select--
GENERAL
OBC
Other
SC
ST
Disability Details
Do you have Disability Certificate?
Yes
No
Bank Details
Bank Name
District
Branch Name
Bank A/C No.
Photograph of Members
Remark:
"Sir,The card is being submitted after all necessary corrections" DEO [rcijalcho6(O0118) ],(Sep 6 2023 4:02PM)
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Live Camera
Captured Picture