Personal Details PERSONAL DETAIL Name: * Date of Birth: * Blood Group: * ---A+A-AB+AB-B+B-O+O- Sex: * ---FEMALEMALE Marital Status: * ---MarriedSeparatedSingleWidowed Caste: * ---GCOBCSCST Religion: * Nationality: * ---AfghanAlbanianAlgerianAmerican **ArgentineArgentinianAustralianAustrianBangladeshiBatswanaBelgianBolivianBrazilianBritishBulgarianCambodianCameroonianCanadianChileanChineseColombianCosta RicanCroatianCubanCzechDanishDominicanDutchEcuadorianEgyptianEmiratiEnglishEstonianEthiopianFijianFinnishFrenchGermanGhanaianGreekGuatemalanHaitianHonduranHungarianIcelandicIndianIndonesianIranianIraqiIrishIsraeliItalianJamaicanJapaneseJordanianKenyanKoreanKuwaitiLaoLatvianLebaneseLibyanLithuanianMalagasyMalaysianMalianMalteseMexicanMongolianMoroccanMozambicanNamibianNepaleseNew ZealandNicaraguanNigerianNorwegianPakistaniPanamanianParaguayanPeruvianPhilippinePolishPortugueseRomanianRussianSalvadorianSaudiScottishSenegaleseSerbianSingaporeanSlovakSouth AfricanSpanishSri LankanSudaneseSwedishSwissSyrianTaiwaneseTajikistaniThaiTonganTunisianTurkishUkrainianUruguayanVenezuelanVietnameseWelshZambianZimbabwean Enquiry Date: Identity Proof(at least one) * Aadhar No.: Voter ID No.: Passport No: Physically Challenged Person YesNo Physically Challenged(%): Present Address Present Address: * City: * PIN: * Country: * ---AfghanAlbanianAlgerianAmericanArgentineArgentinianAustralianAustrianBangladeshiBatswanaBelgianBolivianBrazilianBritishBulgarianCambodianCameroonianCanadianChileanChineseColombianCosta RicanCroatianCubanCzechDanishDominicanDutchEcuadorianEgyptianEmiratiEnglishEstonianEthiopianFijianFinnishFrenchGermanGhanaianGreekGuatemalanHaitianHonduranHungarianIcelandicIndianIndonesianIranianIraqiIrishIsraeliItalianJamaicanJapaneseJordanianKenyanKoreanKuwaitiLaoLatvianLebaneseLibyanLithuanianMalagasyMalaysianMalianMalteseMexicanMongolianMoroccanMozambicanNamibianNepaleseNew ZealandNicaraguanNigerianNorwegianPakistaniPanamanianParaguayanPeruvianPhilippinePolishPortugueseRomanianRussianSalvadorianSaudiScottishSenegaleseSerbianSingaporeanSlovakSouth AfricanSpanishSri LankanSudaneseSwedishSwissSyrianTaiwaneseTajikistaniThaiTonganTunisianTurkishUkrainianUruguayanVenezuelanVietnameseWelshZambianZimbabwean State: * District: * Is Permanent & Present Address same ? YesNo Permanent Address Permanent Address: * City: * PIN: * Country: * ---AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d’IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor-Leste)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonThe GambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesia, Federated States ofMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe State: * District: * Guardian Address same as ? None Present Address Permanent Address Guardians Detail Local Guardian Name: * Relation with Candidate: Guardian Address: City: PIN: Country: State: District:
