Fillable Printable New Ration Card Application Form
Fillable Printable New Ration Card Application Form
New Ration Card Application Form
New Ration
Head of the Household Details
Card Type*:
APL
BPL
AAY
AAP
EID*: ______________________
__________________________
Name of Head of the Family*:
_______
Name of Head of the Family (In local language)
Mother's Name*: __________
____________________________________________________
Mother's Name (In local language)*:
_________
Father's Name*:
__________________
Father's Name (In local language)*: _
__________
Gender*:
Male
Female
Spouse's Name*: _____
______________________________________________________
DOB*: _______
_______________________
Professional Details
Occupation*: ___________________
______________________________________________________
Annual Income*:
_______________________________________
Gas Connection Details
Gas Connection Status*:
Deepam
Gas Company Name*:
_______________
Consumer No
*:
__________________________________
Residence Address
Door No
*
: _______________________
District
*: ______________
__________
Village / Ward
*: _________
_______________
FP Shop No
*:
______________________________
Permanent Address
Door No
*
: _______________________
District
*: ___________
____________
Village / Ward
*: ________
_________________
New Ration
Card Application Form
Head of the Household Details
AAP
__________________________
UID*: ______________
_______
_______
_____________
__________________________________
Name of Head of the Family (In local language)
*: _________________________________
_______
____________________________________________________
__________
_________
__________________________________________
__________________
___________________________________________________
__________
_
___________________________________________
______________________________________________________
____________________
_______________________
___________ Age*: _____________
______________________________________________________
_______________________________________
________________________________________
Double
Single
No Cylinder
_______________
Gas Agency Name
*: ______________________
_________________
__________________________________
: _______________________
Locality / Land Mark
*
: ____________________________________
__________
______
Mandal
*: _______
____________________
_______________
_______
Pin Code:
__________
__________
______________________________
: _______________________
Locality / Land Mark
*
: ____________________________________
____________
_________
Mandal
*: _______
__________________
_________________
________
Pin Code:
_______________
________
_______
______________
__________________________________
_______________
_______
_____________
__________
______
__________________________________________
____________
___________________________________________________
__________
___________________________________________
_________
____________________
______________________________________________________
_________
________________________________________
_________________
: ____________________________________
____________________
______________
__________
______________
: ____________________________________
__________________
______________
________
_________
Add Member Details
:
YES
If Yes, Please Enter Member Details
Member
Name
Gend
er
DOB
(DD/MM
/YYYY)
Mother
Name
Other Details
Old Ration Card No. (If any): __
_______________________________
Informant Details
Informant Name*:
____________________
Delivery Type*:
_______________________________
Proof Document*:
_______________________________________
Documents List
(
NOTE: 1.Total size of all Upload Documents should not be exceeding up to 50 KB.
2. All Upload Documents should be in PDF format only.
Meeseva Application Form*
Proof Document*
Photo*
NO
Father
Name
Spouse
Name
Opting to
Lift
Commodity
(True/False)
Age
EID
_______________________________
_______________________________
____________________
______________ Informant Relation*:
_________________________
_______________________________
Mobile No*: ______________
________________________
_______________________________________
NOTE: 1.Total size of all Upload Documents should not be exceeding up to 50 KB.
2. All Upload Documents should be in PDF format only.
)
Applicant’s Signature
EID
UID Relationship
with Head
of the
Family
_______________________________
_________________________
________________________
NOTE: 1.Total size of all Upload Documents should not be exceeding up to 50 KB.
Applicant’s Signature
