Registration of Consumers for Transparency in PDS

Details of the FPS Dealer for whom information is sought  
District Name * :   Block / ULB * :
GP / Ward No. * :
  Dealer (for Rice/Wheat/Sugar)
*
:
Dealer (for Koil )if different from above
:
Details of the Consumer  
Name   * :   Gender   * :   
Relations Name * :   Relation * :
Mobile / Phone No. * :  
Do you have ration card
*
:  
Are you a member of
:
Declaration : I hereby declare that all the particulars furnished above are correct to the best of my knowledge . I shall be held responsible for any incorrect information.