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________________________________) : of Birth : as on …….. : /Spouse Name : Mother’s Name : (SC / ST / PH / Ex-Serviceman/ Children of Ex-Serviceman / Serving Armed Forces) : for communication : No. (Landline / ) : ID : Registration No. : Aadhaar No. : Qualifications : (SSLC onwards) Sl. No. Course Percentage Name of the Board/ University Year of Study 9. Additional Qualifications : Sl. No. Course Percentage Name of the Board/ University Year of Study