Beehaar Ispesal

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Bihar ispecial :

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DRIVING LICENSE APPLIKASON PHOROM

NOTE: If you dot knows, please copy from another applikason

phorom.

For phurthar instructions, see bottom applikason.

Please do not soot the person at the applikason kounter. He will

give you the licen.

 

Last name:

(_) Yadav

(_) Sinha

(_) Pandey

(_) Misra

(_) Dot no

(Check karet box)

 

 

First name:

(_) Ramparshad

(_) Lakhan

(_) Sivparshad

(_) Jamnaparshad

(_) Dot no

(Check karet box)

 

Age:

(_) Less than phipty

(_) Greater than phipty

(_) Dot no

(Check karet box)

 

Sex: ____ M _____ P(F) _____ not sure _____not applicable

Chappal Size: ____ Lepht ____ Right

 

> >>>>Occupason:

> >>>>(_) Politison

> >>>>(_) Doodhwala

> >>>>(_) Pehelwaan

> >>>>(_) House wife

> >>>>(_) Un-employed

> >>>>(Check karet box)

Number of children libing in the household: ___

Number that are yours: ___

 

Mother name: _______________________

Phather Name: ____________________ (If not no, leave blank)

Ejjucason: 1 2 3 4 (Circle highest grade completed)

 

Dental rekard:

(_) Ellow

(_) Berownish-ellow

(_) Berown

(_) Belack

(_) Other - Give egjhakt color

(Check karet box)

 

Your thumb imparesson

(If you are copying from another applikason pharom, please do not

copy thumb

impression also. Please provide your own thumb impression.)

 

PELEASE DO NOT USE PHINGERS OF YOUR LEGS

Use thumb on your lepht hand only. If you dont have lepht hand,

use your thumb on right hand. If you do not have right hand, use thumb on lepht hand.

NOTE : IF YOU DONT HAVE BOTH HANDS, YOU CANNOT DRIVE. WE ARE VARY ISTRICT ABOUT THIS