Registration Form (Basic First Aid Training for Driving Licence)
  
Personal  Details     
       
Candidate's Name* :    Father/Husband Name* :   
Date of Birth* :          Gender* : 
Blood Group* :    Education/Qualification :   
       
Contact  Details        
       
Address/Locality* :    City/Town/Village :   
Tehsil/Post Office :    District* :   
State* :    PinCode* :   
Mobile No.* :    Email ID   :   
       
Upload  Photo       
  If Photo is not loaded in appropriate format, your application is liable to get rejected.
  Allowed Photo Size - 10KB to 100 KB File Type : *.jpeg, *.gif, *.png
       
Upload Photo * :   
 
       
Security  Code        
 
 
   
Enter Security Code * :         
 
 
   I hereby declare that the information given in this application is true and correct to the best of my knowledge