Personal Information Form

Registration Number (दर्ता नम्बर):
🆔 0074

Personal Details

📝 Full Name (पूरा नाम): Patte Bhutia
🎂 Date of Birth (जन्म मिति): 05/11/1976
🚺 Gender (लिङ्ग): Female (महिला)
👨‍👩‍👧 Father’s / Husband’s Name (बुबा / श्रीमानको नाम): LT. Fhuntsok Phurik
👩‍👧 Mother’s Name (आमाको नाम): Lt. Keepa Bhutia

Contact Information

📞 Phone Number (फोन नम्बर): 9734127925
📧 Email ID (इमेल ठेगाना): (If needed)

Identification Details

🆔 Aadhar Card Number (आधार कार्ड नम्बर): 562031667548
🗳️ Voter Card EPIC Number (मतदाता कार्ड EPIC नम्बर): IBN1388099

Address Information

Permanent Address (स्थायी ठेगाना):
📍 Toong Soong RD, Ward No 14, Darjeeling, West Bengal
📮 PIN Code (पिन कोड): 734101

Temporary Address (अस्थायी ठेगाना):
📍 Toong Soong RD, Ward No 14, Darjeeling, West Bengal

Work Information

💼 Work Sector (कामको क्षेत्र): Garment Hawkers (19)
💼 Work Experience (कार्य अनुभव): 35 years

Declaration

📝 Declaration (घोषणा):
"I agree to the declaration / म घोषणामा सहमत छु”

Blood Group

🩸 Blood Group (रक्त समूह): (Not provided)