GONDWANA GOND MAHASABHA & TRAIN JATRA ID FORM

D-15/1, Unit IX Flat, Bhubaneswar – 751022, Ph – 0674-2542640, M – 9437446346
E mail – gondsamaj.odisha@gmail.com, Website – www.gondmahasabha.com

 

Name of Board*
Name of Gada* Name of Post *
State
District
Block
Gudi/Palli/Punja
Name So/Wo/Do
Passport Photo      
Birth Date     Age   Blood Group
Gender Male   Female Diya Bansha
Mobile Phone (+91) Gotra
Current E-Mail ID Profession

Correspondence Details [Present Address]                           Same Address                           [Permanent Address]                       

Street/Village* Street/Village*
Post Office* Post Office*
Via Via
City City
State* State *
District* District *
Block Block
Punja/Palli/Gudi Punja/Palli/Gudi
Pin* Pin *
 
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