Application Form For Village level Entrepreneur (VLE)
Aadhaar Number    
LMK Puposed Location Details
District :   Block :  
Area Type:  
Panchayat :  
Village :  
IPH Division :   IPH Sub Division :  
HPSEBL Division:   HPSEBL SubDivision :  
Applicant Details
Name :   Father's Name :  
Date of Birth :   Gender :  
Marital Status :
 
Religion :
 
Qualification :   Type of Employment :  
PAN Card No :   Email ID :      
Mobile Number :   Other Contact Number :
LokMitra Kendra Address :   VLEs Present Address :  
PinCode LokMitra Kendra Address :   PinCode of VLEs Present Address:  
Type the characters of below image
(Image Characters are Case Sensitive)