Panchayat:Repo18/Law Manual Page0421

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Sl. No. of ....................................

Roll ..............................................

List of Amendments 19.........

Additions
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)