DERIVING LICENSE APPLIKASON PHOROM
NOTE: Please do not soot the person at the applikason kounter. He will give you the licen.
If you dot know how to fill ,copy from your phriend (dost)applikason.
For phurthar instructions, see bottom applikason.
1. Last name: (_) Yadav (_) Sinha (_) Pandey (_) Misra (_) Dont no
(Check karet box)
2. phust name: (_) Ramprasad (_) Lakhan (_) Sivprasad (_) Jamnaprasad (_) Dont no
(Check karet box)
3. Age: (_) Less than phipty (_) Greater than phipty (_) Dont no
(Check karet box)
4. Sex: ____ M _____(F) _____ not sure _____not applicable
5. Chappal Size: ____ Lepht ____ Right
6.Occupason: (_) Politison (_) Doodhwala (_) Pehelwaan (_) House wife (_) Un-employed
(Check karet box)
7. Number of children libing in the household: ___
8. Number that are yourj: ___
9. Mather name: _______________________
10. Phather Name: ____________________
(If not no,leabe blank)
11. Ejjucason: 1 2 3 4
(Circle highest kilass attended)
12. Your thumb imparesson : ____________________________
(If you are copying from another applikason pharom, pleaje do not copy thumb impression also. Pleaje provide your own thumb impression.)
PELEAJE DO NOT USE PHINGERS OF YOUR LEGS
Use thumb on your lepht hand only. If you dont have le pht 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 DERIVE. WE ARE VARY ISTRICT ABOUT THIS
NOTE: Please do not soot the person at the applikason kounter. He will give you the licen.
If you dot know how to fill ,copy from your phriend (dost)applikason.
For phurthar instructions, see bottom applikason.
1. Last name: (_) Yadav (_) Sinha (_) Pandey (_) Misra (_) Dont no
(Check karet box)
2. phust name: (_) Ramprasad (_) Lakhan (_) Sivprasad (_) Jamnaprasad (_) Dont no
(Check karet box)
3. Age: (_) Less than phipty (_) Greater than phipty (_) Dont no
(Check karet box)
4. Sex: ____ M _____(F) _____ not sure _____not applicable
5. Chappal Size: ____ Lepht ____ Right
6.Occupason: (_) Politison (_) Doodhwala (_) Pehelwaan (_) House wife (_) Un-employed
(Check karet box)
7. Number of children libing in the household: ___
8. Number that are yourj: ___
9. Mather name: _______________________
10. Phather Name: ____________________
(If not no,leabe blank)
11. Ejjucason: 1 2 3 4
(Circle highest kilass attended)
12. Your thumb imparesson : ____________________________
(If you are copying from another applikason pharom, pleaje do not copy thumb impression also. Pleaje provide your own thumb impression.)
PELEAJE DO NOT USE PHINGERS OF YOUR LEGS
Use thumb on your lepht hand only. If you dont have le pht 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 DERIVE. WE ARE VARY ISTRICT ABOUT THIS
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