[webvg~j weZiYi Rb]

wn`y agxq KjvY Uv

(ag welqK gYvjq)

1/AvB, cwievM, kvnevM, XvKv-1000

wn`yagxq mveRbxb cwZvb (gw`i/gV/Avkg/kkvb/BZvw`) msvi/givgZ/cybwbgvY

Aby`vbi Rb Ave`b|

1|

cwZvbi bvg :

2|

wVKvbv : Mvg :............................................... BDwbqb/IqvW : ............................................

WvKNi : ........................................... DcRjv...............................Rjv :..........................

_ ZQwC\DJ[T.MY<8Y*L=YZM.YI\ZLE~ALKZCBYg.

_

FZ=YgELHYV.ZQPYH.HYVg.LEYJ

/NY/YLEYJ.......................................................0ZQPYHE~AL..........................................
5| mevBZi bvg/ eevcbv KwgwUi gqv` I ZvwjKv : (mshy KvMR)
6| K) cwZvbwU Ke cwZwZ nqQ ? : ..........................................
L) cwZvbwU wbR^ Rwgi Dci cwZwZ wK ? .................................
0FZ=YEZ8LnYHLP~ZLPVZZHHL<
7| cwZvbwUi MZ A_ eQii evwlK Avq KZ?
8| cvw_Z Aby`vbi cwigvY Ges wK KvR eq Kiv ne :
_ZQwC\DJ[T.MY<8YQg=%Z=FagHFY$E\CYgELFZLJY<H4LZIZ.
10| AxKvibvgv :
*%JgJ $[.YLFCYE.LZ4fK$YgHCEFgHZ<==BYZCP~a< P=_f.YE=Bf0YFE.ZLZE_FZ=YgEL
$E\.agM$BHLYQgM=Y'ExTEPVkYLF\EZEJYg<P\]IYgHHT.LH*HVKBYPJgTZQPYHCYZ/M.LH_
PIYFZ=P~YCg.LAYL
c~Y bvg :
wmj :
(cwZvbi wmjgvni)

gvevBj/Uwjdvb bs-

$FLFdYLCH

(2)
cZqb c
11| cZqb Kiv hvQ h, ............................................................................... cwZvbwU A
GjvKvq AewZ Ges RvbvgZ Ave`bKvix KZK c` Z_vw` mwVK| Ave`bKZ A_ gyi Kivi Rb mycvwik
Kiv njv|
(K) ^vi I wmj
(L) ^vi I wmj
Pqvigvb, BDwbqb cwil`
A_ev
Kwgkbvi/KvDji, cimfv/wmwU Kcvikb

Pqvigvb, DcRjv cwil`/

DcRjv wbevnx KgKZv
A_ev
gqi, cimfv/wmwU Kcvikb

(M) gvbbxq msm` m`mi cZqb

12| ewYZ cwZvbwU Avgvi wbevPbx GjvKvq AewZ Ges mveRbxb cwZvb wnme Aby`vbi Rb Rvi mycvwik
KiwQ|
^vi I wmj
wekl `e t
(1) Dciv 3wU cZqbi ga h Kvb `yBwU cZqbc MnYhvM|
(2) A Aby`vb dg Uvi IqemvBU cvIqv hvQ| dUvKwcI MnYhvM|

 $P~a<$YgHCEHYZ=MHgM0<QgH_
(4) Kvb Z_ Mvcb Kiv nj Aby`vb evwZjmn AvBbvbyM eev MnY Kiv ne|
..............................................................................................................................................
(bxPi Ask Awdm KZK eenvh)
gywi mycvwik
wn`y agxq KjvY Uvi 201

............................ A_eQi wekl/HwQK/Rjv eiv nZ Dciv

FZ=YEZ8L$E\.agM............................ (K_vq .................................................) UvKvi Aby`vb c`vb

hZ cvi|
^vi I wmj
Pqvigvb/fvBm Pqvigvb/Uvw/mwPe
eiv c t .........................................................*L$E\.bgM........................... (K_vq ..............
....................... UvKv) Gi GKwU m&W PK bs ......................... Zvs- .................... wLt, RbZv evsK wj:,
wRiv cqU kvLv, XvKv Bmy Kiv njv|
cyZKvix mnKvix

wnmveiK

mwPe

fvBm Pqvigvb/ Uvw