Panchayat:Repo18/Law Manual Page0420

FORM 1
(See Rule 3)
Electoral Roll 20……
………...….. (Constituency No.)/ ……………. (Name of Panchayat) Grama Panchayat Constituency
PART ………………

Name of Polling Station………………………………….. No. of Polling Station …………………………………….. Area of Polling Station ……………………………………

[………………………….. (Constituency No.)/ ………………………. (Name of Panchayat) Grama Panchayat Constituency Electoral roll Part ………….…………]

[………………………….. (Constituency No.)/ ………………………. (Name of Panchayat) Block Panchayat Constituency Electoral roll Part …………....…………]

[………………………….. (Constituency No.)/ ………………………. (Name of Panchayat) District Panchayat Constituency Electoral roll Part ……………………]

Sl. No.
House No. & House Name (in bracket)
Name of Elector
Name of Father/ Mother/ Karanavan/ Husband
Male/ Female
Age as on 1st January 1994
(1)
(2)
(3)
(4)
(5)
(6)

Electoral Registration Officer


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