Covid 19 Pandemic Emergency Identity Card

  1. Name of the Empoloyee/Vendor*


Fill in CAPITAL LETTERS ONLY

  1. Father/Husband's Name


Fill in CAPITAL LETTERS ONLY

  1. Department


Indicate Department

  1. Designation


Indicate your designation

  1. Type of Vendor


Vegetables/Milk/etc

  1. Vehicle No.


Indicate Vehicle No

  1. Type of Vehicle

  2. Two Wheeler

  3. Three Wheeler

  4. Four Wheeler

Enter type of vehicle

  1. Village and mandal*


Selling village and mandal

  1. Aadhar No.*


please put space after four numbers as XXXX XXXX XXXX

  1. Residece Village


  1. Mandal


  1. District


  1. Mobile Number*


  1. Upload Photo*

Accepted file types: jpg, png, pdf.

Please upload a good quality image

  1. Signature of Issuing Authority*

Accepted file types: jpg, png, pdf.

Please upload a good quality image

  1. Stamp of Issuing Authority*

Accepted file types: jpg, png, pdf.

Please upload a good quality image

  1. Issuing Authority Mobile Number*


To conform your Identity

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