Covid 19 Pandemic Emergency Identity Card
Name of the Empoloyee/Vendor*
Fill in CAPITAL LETTERS ONLY
Father/Husband's Name
Fill in CAPITAL LETTERS ONLY
Department
Indicate Department
Designation
Indicate your designation
Type of Vendor
Vegetables/Milk/etc
Vehicle No.
Indicate Vehicle No
Type of Vehicle
Two Wheeler
Three Wheeler
Four Wheeler
Enter type of vehicle
Village and mandal*
Selling village and mandal
Aadhar No.*
please put space after four numbers as XXXX XXXX XXXX
Residece Village
Mandal
District
Mobile Number*
Upload Photo*
Accepted file types: jpg, png, pdf.
Please upload a good quality image
Signature of Issuing Authority*
Accepted file types: jpg, png, pdf.
Please upload a good quality image
Stamp of Issuing Authority*
Accepted file types: jpg, png, pdf.
Please upload a good quality image
Issuing Authority Mobile Number*
To conform your Identity