Complaint & Grievances Management System
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Complainer Details
Name
*
:
Gender
:
Male
Female
Address
*
:
Pincode
:
Police Station
:
Post Office
:
State
:
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Uttar Pradesh
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District
:
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E-Mail ID
:
Mobile No.
*
:
Landline No.
:
Complain Details
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Area
:
Location
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Language of Grievance Detail
:
Hindi
English
* Have you earlier lodged the grievance to the above organisation on the same subject?
:
Yes
No
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I hereby state that the facts mentioned above are true to the best of my knowledge and belief.