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Lodge Grievance (Fields with * are mandatory)
Applicant Details
Name of the applicant*
Gender
Address
PIN Code
Phone Number(Land Line)
(example: 01122564799)
Phone Number(Mobile)
(example: 9441145679)
E-Mail ID
Grievance Location Details
Zone*
Ward
Colony
Address*
PIN Code
Grievance Details
Frequently Filed Grievance Types
Grievance Category
Grievance Sub Category
Subject*
Grievance Description*
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