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Employee Identity Card Form
Fields marked with * are mandatory
1. Name*
(in Full, as required to be printed on ID)
2. Designation*
3. Place of Posting *
4. Blood Group*
5. Date of Birth*
6. Email Address*
7. Home Address *
8. Primary Contact Phone No/Mobile No.*
9. Alternate Address*
10. Secondary Contact Phone No/Mobile No *
11. Emergency Contact Phone No*
Declaration
I certified that information provided by me and information contained herein is my own and is true, correct and accurate.
Upload Photo
(File Format: gif,jpeg,png,jpg|Image Max Size: 110px X 110px & 50 KB,to be used for print on ID Card)

Applicant's Sigunature/Thumb Print
(File Format: gif,jpeg,png,jpg|Image Max Size: 110px X 110px & 50 KB,to be used for print on ID Card)