Name:*

Father's Name:*

Gender:*
---MaleFemaleOther

Mobile Number:*

Email:*

Date of Birth:*

Mother Tongue:*

Edu Qualification:*
---8th PassMadhyamik PassH.S PassGraduationMastersPh.D

Extra Curriculum:

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Epic No (Voter ID):*


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State:*
West Bengal

District:*
---AlipurduarBankuraPaschim BardhamanPurba BardhamanPuruliaBirbhumCooch BeharDarjeelingDakshin DinajpurUttar DinajpurHooghlyHowrahJalpaiguriJhargramKolkataKalimpongMaldaPaschim MedinipurPurba MedinipurMurshidabadNadiaNorth 24 ParganasSouth 24 Parganas

Sub Division:*
---Alipore SadarAlipurduarArambaghAsansolBalurghatBangaonBankuraBarasatBarrackporeBaruipurBardhaman Sadar NorthBardhaman Sadar SouthBasirhatBaharampurBidhannagarBishnupurBolpurCanningChanchalChandannagarChinsurahContaiCoochBehar SadarDarjeeling SadarDiamond HarbourDomkalDinhataDurgapurEgraGangarampurGhatalHaldiaHowrah SadarIslampurJalpaiguri SadarJangipurJhaldaJhargramKakdwipKandiKalnaKalyaniKalimpong SadarKatwaKrishnanagar SadarKharagpurKhatraKurseongLalbagMalbazarMalda SadarManbazarMathabhangaMedinipur SadarMekhliganjMirikPurulia SadarPurulia Sadar WestRaghunathpurRaiganjRampurhatRanaghatSiliguriSriramporeSuri SadarTamlukTehattaTufanganjUluberia

Police Station:*
---AdraAirportAirportAlipurduarAmdangaAmtaAmtaAnandapurAndalArambagArshaAsansol NorthAsansol South WomenAshoknagarAshugramBaduriaBagdahBagdograBaghmundiBagnanBaguiatiBaguiatiBaharampurBaishnabnagarBalagarhBalarampurBallyBalurghatBamangolaBanarhatBandwanBangaonBankuraBansihariBarabaniBarabazarBaranagarBarasatBarikulBarjoraBarrackporeBaruipurBasantiBasirhatBauriaBeldaBeldangaBelghariaBeliaberahBeliatoreBelpahariBhabanipurBhadreswarBhagabanpurBhagawangolaBhaktinagarBhangarBharatpurBhatarBhatparaBhupatinagarBidhannagar ( North)Bidhannagar (East)Bidhannagar (South)BidshnupurBijpurBhutniBinpurBirparaBishnupurBolpurBoroBud BudBudge BudgeBurdwanBurwanCanningChakdahaChakuliaChanchalChandannagarChandipurChanditalaChandrakonaChandrapurChapraChhatnaChinsurahChittaranjanChopraCoke OvenContaiCooch BiharDadpurDalkholaDankuniDantanDarjeeling ( Sadar)DashpurDaulatabadDebraDegangaDhaniakhaliDhantala , GangnapurDholahatDhubuliaDhupguriDiamond HarbourDighaDigha Mohana CoastalDinhataDomjurDomkolDubrajpurDum DumDurgachakDurgapurDuttapukurEgraElectronic complexEnglish BazarFalakataFaltaFarakkaFaridpurFraserganj CoastalGaighataGalsiGangajalghatiGangarampurGangasagar CoastalGarhbetaGazoleGhatalGhoksadangaGholaGoalpokharGoaltoreGobardangaGobardhanpur CoastalGoghatGopalnagarGopiballavpurGorubathanGosabaGurapHabibpurHabraHaldiaHaldibariHanskhaliHariharparaHaringhataHaripalHarirampurHarishchandrapurHaroaHarwood Point CoastalHasnabadHemnagarHemtabadHiliHingalganjHirapurHirbandhHogalbariaHuraIlambazarIndasIndpurIslampurIslampurItaharJagachaJagaddalJagatballavpurJaigaonJalangiJaldhakaJalpaiguriJamalpurJamboniJamuriaJangiparaJaynagarJaypurJaypurJaypurJhaldaJhargramJharkhali CoastalJiaganjJibantalaJorebunglowKakdwipKalchiniKaliachakKaliganjKaliaganjKaliyaganjKalimpongKalnaKalyaniKandiKankartalaKanksaKarandighiKarimpurKashipurKashipurKatwaKendaKeshiariKeshpurKetugramKhanakulKhandaghoshKharagpur (Local)Kharagpur (Town)KhardahaKhargramKhatraKhejuriKhoribariKhoyrasolKolaghatKolkata Leather ComplexKotshilaKotulpurKotwaliKrishnaganjKulchibariKulpiKultaliKultiKumarganjKumargramKurseongKushmandiLabhpurLake TownLalgarhLalgolaLiluahLodhamaLokpurMadarihatMadhabdihiMadhyamgramMagrahatMaheshtalaMahishadalMainaguriMaipit CoastalMalbazarMallarpurManbazarMandirbazarMangalkoteManikchakMargramMarishdaMathabhangaMathurapurMatiaMatigaraMayureswarMedinipurMejiaMekhliganjMemariMetiabruzMinakhanMirikMograMohammad BazarMohanpurMonteswarMothabariMoynaMuraraiMurshidabadMurutiaNabadwipNabagramNadanghatNaihatiNakashiparaNalhatiNamkhanaNandakumarNandigramNanoorNaodaNaoparaNarayangarhNarayanpurNarendrapurNaxalbariNayagramNazatNetaji Subhas Chandra International AirportNew BarrackporeNew JalpaiguriNew TownNew TownNew TownshipNimtaNituriaNodakhaliOld MaldaOndaPaikarPalashiparaPanchlaPandabeswarPanduaPanruiPanskuraParaParulia CoastalPatashpurPatharpratimaPatrasayerPatulighat (Junput) CoastalPetrapolePhansidewaPinglaPolbaPradhan NagarPukhuriaPulbazarPunchaPurbasthaliPursurahPurulia ( Muffasil)Purulia ( Town)Purulia Sadar WomenRabindranagarRaghunathganjRaghunathpurRaidighiRaiganjRainaRaipurRajarhatRajarhatRajganjRajnagarRamnagarRampurhatRanaghatRangli – RangliotRanibandhRaniganjRaninagarRanitalaRatuaRejinagarRishraSabangSadaipurSagarSagardighiSahebganjSaktigarhSainthiaSalanpurSalarSalboniSaltoraSamserganjSamuktalaSandeskhaliSankrailSankrailSantaldihSantiniketanSantipurSanturiSarengaShaktipurShasanShyampurSiliguriSimlapalSingurSitaiSitalkuchiSonamukhiSonarpurSrirampurSukhiapokhariiSundarban CoastalSuriSutahataSutiSwarupnagarTaherpurTaldangraTalpatighat CoastalTamlukTapanTarakeswarTarapithTehattaThanarparaThanapurTitagarhTufanganjUdaynarayanpurUluberiaUsthiUttarparaWomen PS Burdwan

Block:*
---Alipuduar IAlipuduar IIAmdangaAmta IAmta IIAndalArambagArshaAsansolAshugram IAshugram IIBaduriaBagdahBaghmundiBagnan IBagnan IIBalagarhBalarampurBally JagachhaBalurghatBamangolaBandwanBangaonBankura IBankura IIBansihhariBarabaniBarabazarBarasat IBarasat IIBarjoraBarrackpore IBarrackpore IIBaruipurBasantiBasirhat IBasirhat IIBeldanga IBeldanga IIBerhamporeBhagabanpur IBhagabanpur IIBhagawangola IBhagawangola IIBhangar IBhangar IIBharatpur IBharatpur IIBhatarBinpur IBinpur IIBishnupurBishnupur IBishnupur IIBolpur SriniketanBudge Budge IBudge Budge IIBurwanBurdwan IBurdwan IICanning ICaning IIChakdahaChanchal IChanchal IIChandipurChanditala IChanditala IIChandrakona IChandrakona IIChandrapurChapraChhatnaChinsurahChopraContai IContai IIICooch Bihar ICooch Bihar IIDadpurDantan IDantan IIDarjeeling – PulbazarDashpur IDashpur IIDebraDegangaDeshpranDhaniakhaliDhupguriDiamond Harbour IDiamond Harbour IIDinhata IDinhata IIDomjurDomkolDubrajpurDurgapurEgra IEgra IIEnglish BazarFalakataFaltaFarakkaFaridpurGaighataGalsi IGalsi IIGangajalghatiGangarampurGarhbeta IGarhbeta IIGarhbeta IIIGazoleGhatalGoalpokhar IGoalpokhar IIGoghat IGoghat IIGopiballavpur IGopiballavpur IIGorubathanGosabaHabibpurHabra IHabra IIHaldiaHaldibariHanskhaliHariharparaHaringhataHaripalHarirampurHarishchandrapur IHarishchandrapur IIHaroaHasnabadHemtabadHiliHingalganjHirapurHirbandhHuraIlambazarIndasIndpurIslampurItaharJagatballavpurJalangiJalpaiguriJamalpurJamboniJamuriaJangiparaJaynagar IJaynagar IIJaypurJhalda IJhalda IIJhaldaJhargramJorebunglow – SukhiapokhariiKakdwipKalchiniKaliachak IKaliachak IIKaliachak IIIKaliganjKaliaganjKalimpong IKalimpong IIKalna IKalna IIKancharaparaKandiKanksaKarandighiKarimpur IKarimpur IIKashipurKatwa IKatwa IIKershiariKeshpurKetugram IKetugram IIKhanakul IKhanakul IIKhandaghoshKharagpur IKharagpur IIKhargramKhatraKhejuri IKhejuri IIKhoribariKhoyrasolKolaghatKotshilaKotulpurKrishnaganjKrishnanagar IKrishnanagar IIKulpiPatharpratimaKultaliKultiKumarganjKumargramKurseongKushmandiLabhpurLalgolaLokpurMadarihatMagrahat IMagrahat IIMaheshtalaMahishadalMainaguriMaldaMalbazarMallarpurManbazar IManbazar IIMandirbazarMangalkoteManikchakMathabhanga IMathabhanga IIMathurapur IMathurapur IIMatigaraMayureswar IMayureswar IIMedinipur SadarMejiaMekhliganjMemari IMemari IIMinakhanMirikMograMohammad BazarMohanpurMonteswarMoynaMothabariMurarai IMurarai IIMurshidabad – jiaganjNabadwipNabagramNakashiparaNalhati INalhati IINamkhanaNandakumarNandigram INandigram IINanoorNaodaNarayangarhNaxalbariNayagramNituriaOld MaldaOndaPaikarPanchlaPandabeswarPanduaPanskuraParaPatashpur IPatashpur IIPatharpratimaPatrasayerPhansidewaPinglaPolbaPunchaPurbasthali IPurbasthali IIPursurahPurulia (Muffasil)Purulia IPurulia IIRaghunathganj IRaghunathganj IIRaghunathpur IRaghunathpur IIRaiganjRaina IRaina IIRaipurRajarhatRajganjRajnagarRamnagar IRamnagar IIRampurhat IRampurhat IIRanaghat IRanaghat IIRangli – RangliotRanibandhRaniganjRaninagar IRaninagar IIRatua IRatua IISabangSagarSagardighiSagunaSahid MatanginiSainthiaSalanpurSalboniSaltoraSamserganjSandeskhali ISandeskhali IISankrailSantiniketanSantipurSanturiSaratiSarengaShibpurShyampur IShyampur IISimlapalSingurSitaiSitalkuchiSonamukhiSonarpurSrirampur UttarparaSuri ISuri IISutahataSuti ISuti IISwarupnagarTaldangraTamlukTapanTarakeswarTarapithTehatta ITehatta IIThakurpukurTufanganj ITufanganj IIUdaynarayanpurUluberia IUluberia II

Panchayet/Municipality:*

Village/Area:*


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