Saturday, March 13, 2010

The Data

From


Mr. Dayanidhi Behera, Postal Inspector, Sonepur-767017

Mob- 9437639099 Email-behera.dayanidhi71@gmail.com

URL Address- www.maudamani.blogspot.com

The Data and information may be sent to me on the above address in English to contact you easily and for future referrence. Thank you for your co-operation.

                                                                The blogger



DATABASE FORM (FOR WRITERS ONLY)

1. My Name :

2. My Father’ Name :

3. My Mother’ Name :

4. My Date of Birth :

5. My Birth Place/ District :

6. My Mob. No. :

7. My Email Address (If Any) :

8. My Present Address :





9. My Permanent Address :





Signature/ Date