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GRIEVANCE

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Lodge a Complaint
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Date : 4/2/2012
f'kdk;rdrkZ dk uke (Complaint Lodger's Name)
firk@ifr dk uke (Father's/Husband's Name)
irk (Address)
x‚o@'kgj (Village, City)
ftyk (District)
f'kdk;r fdlds fo:} (Complaint Against)
f'kdk;r dk fooj.k (Details of Complaint)
bZ&esy dk irk  (E-mail id)
nwj“k"k uEcj & dk;kZy; (Phone No - Office)
nwj“k"k uEcj & Äj (Phone No - Residence)
eksckby uEcj (Mobile No)

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