JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
DDUGKY MRC
FIELD REGISTRATION OF CANDIDATES
Sign in to Google
to save your progress.
Learn more
* Indicates required question
NAME OF THE CANDIDATE
*
Your answer
VILLAGE
*
Your answer
POST OFFICE
*
Your answer
GRAM PANCHAYAT
Your answer
BLOCK
*
Your answer
POLICE STATION
*
Your answer
DISTRICT
*
PURBA MEDINIPUR
PURULIA
PASCHIM BARDHAMAN
PIN CODE
*
Your answer
DATE OF BIRTH
*
MM
/
DD
/
YYYY
AGE
*
Your answer
GENDER
*
MALE
FEMALE
CATEGORY
*
SC
ST
OBC
PWD
GENERAL
CATAGORY UNDER BPL (Please choose any one)
*
BPL Card of self or your household (where your name is also mentioned).
MGNREGA worker card of any household, with a minimum of 15 days of completed work in the last 12 months.
RSBY card of your household.
AAY (Antyodaya Anna Yojana) card of your household.
NRLM- Self Help Group identification of certificate for any member of your household.
BPL PDS card of your household.
Family members of SHG members of a registered SHG in the village.
Family members of paid workers under the MGNREGS with a minimum of 15 days of work in the last 12 months.
MINORITY
*
YES
NO
HIGHEST EDUCATION
*
Your answer
CONTACT DETAILS
*
Your answer
EMAIL ID
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
