Haihaivanshiya Samaj (जनगणना)
Only Married Person should be filled this form individually (if Person living jointly fill this form separately)
Email address
Total Number of Family Members/कुल परिवार के सदस्यों की संख्या
Your's Name (Self)/आपका नाम
Your answer
Wife's Name/पत्नी का नाम
Your answer
Father's Name/पिता का नाम
Your answer
Mother's Name/माता का नाम
Your answer
Date of Birth/जन्म की तारीख
MM
/
DD
/
YYYY
Place of Birth/जन्म स्थान
Your answer
Nationality/राष्ट्रीयता
Your answer
Education /शिक्षा
Your answer
Profession /व्यवसाय
Your answer
Place of Origin /मूल जन्म स्थान
Your answer
Full Address/पूरा पता
Your answer
State/राज्य
Your answer
PIN Code /पिन कोड
Your answer
Contact No. (Mobile/Phone No.)/संपर्क नंबर (मोबाइल / फोन नं)
Your answer
E-Mail Address/ ईमेल
Your answer
Gotra/गोत्र
Your answer
Details of Children/बच्चों का विवरण
Number of Children/बच्चों की संख्या
1. Child Name/बच्चे के नाम
Your answer
Male/Female (स्त्री व पुरुष)
Your answer
Date of Birth/जन्म की तारीख
MM
/
DD
/
YYYY
2. Child Name/बच्चे के नाम
Your answer
Male/ Female (स्त्री व पुरुष)
Your answer
Date of Birth/जन्म की तारीख
MM
/
DD
/
YYYY
3. Child Name/बच्चे के नाम
Your answer
Male/Female (स्त्री व पुरुष)
Your answer
Date of Birth/जन्म की तारीख
MM
/
DD
/
YYYY
4. Child Name/बच्चे के नाम
Your answer
Male/Female (स्त्री व पुरुष)
Your answer
Date of Birth/जन्म की तारीख
MM
/
DD
/
YYYY
Other Information, if any / अन्य जानकारी, यदि कोई हो
Your answer
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