ServicePlus- Application for e-Permission of Holy dip at Parshuram Kund

ServicePlus metadata based service delivery framework - Goverment of India

GOVT OF ARUNACHAL PRADESH
OFFICE OF THE DEPUTY COMMISSIONER
LOHIT DISTRICT :: TEZU

Application Form for e-Permission of Holy dip at Parshuram Kund

Applicant Details

Full Name of Applicant *

Age of Applicant(Not Less than 10 Years and not more than 65 Years) *

Expected Date of Entry to take Holy dip at Parshuram Kund *

Mobile Number *

E-Mail

Whether tested Positive for COVID-19 in the past 15 (fifteen) days:- *

Yes

Present Address

State *

District *

Whether Family Members to be Included ? *

Yes

Total Members *

Details of Family Members

Hide Section

Add Family Members *

Full Name *

Age *

Full Name *

Age *

Declaration

I do hereby declare that the above particulars are true and correct to the best of my knowledge and belief and in case of any false statement / information shall be liable for any action under appropriate section of law.

I Agree *

Additional Details

Apply to the Office*

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