Ration Card

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Commisg Qne

AD E (Ration Card) 7 T| URA, 2oJ07

D TË (Ration Card) I e EK ANRI

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Government of Assam

Food, Civil Supplies & Consumer Affairs Department

GoVERNMENT OF ASSAM

National Food Security Act, 2013/21 T R , o39

RATION CARD AD IÉ
Ration Card Type/ AAY/PHH

Ration Card Number/ CaB TÉ T7


Name of Head of Family/
8 s L
** ***«***

Member ID of HoF
18
Date of Birth/ Age of HoF Froaey u f / q : M SYears/
AADHAAR No. of HoF

Gender of the HoF Male (1T) /Female (afR) /Others (T)

Permanent Address of Ration Card

Father (re)/TM (Husband): ...


Village (mé)/ Town (5):.
************'
A (* ... ***************

Ward No. (SA):.******************** * House No. (aR) : .oo


Sub-Division (T) .T . District (t):
Number &Name of LAC/aMtA7e1 afs4 ya e a .
Name of Gaon Panchayat/ "m4 vurq Ht:

Fair Price Shop ID& Name

Total Family Member/fraYo awj INII

Dateof Isue of Ratlon Card ((q#1Ó f4waq efaN):


Toll Free No. ( ar AA) 1967/1800-345-3611 (De9/boo-98-999)
(4)
Details of Family Members/ t 7U fa49
DOB/Gender Relation Member
Member Name ge
with HoF Aadhaar
Member D/ xWT PAtS MFO
f4(

8
8
o4
1 8

i8 o6 ie p0||(I
8
09

Address of the Fair Price Shop

Name of GPSS/WCCS/LAMPS:

Address of the nearest Food, Civil Supplies &C.A. Office

Address of the Food, Civil Supplies & Consumer Affairs Department


16t Floor, Block-i, Janata Bhawan, P0: Dispur, Distriet: Kamup Metropolitan
PIN: 781006,

Date Signature & Seal offthe Issuing Oficer

Toll Free No. ( T)&1967/1800-345-3611 (au/sboo-080-oUs )


() nspccr,
FCS&CA, Dnubr1.

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