ServicePlus- Application for Senior Citizen Identity Card

ServicePlus metadata based service delivery framework - Goverment of India

APPLICATION FOR ISSUANCE OF SENIOR CITIZEN ID CARD

Application Processing Location

Select the office where the Application has to Process *

Select District *

Applicant Details

Salutation of Applicant *

Name of Applicant *

Salutation of Father/Husband *

Father’s/Husband’s Name *

Date of Birth *

Gender *

Male

Female

Transgender

Mobile Number *

Aadhar Number

E-Mail

Visible Identification Mark *

Height (in cm) *

Major Ailment

Blood Group *

Nationality *

Applicant Photograph *

Address

Present Address

Village/Sector *

Post office *

Police Station *

Pin Code *

State *

District *

Permanent Address

Same as Present Address

Village/Sector *

Post Office *

Police Station *

Pin Code *

State *

District *

Declaration

I do hereby declare that the above contents and supporting documents are correct to the best of my knowledge and belief and nothing has been concealed therein. I am aware that in case the information furnished above is found to be incorrect, I shall be liable for prosecution under Section 177 & 191 of the Indian Penal Code, which stipulates imprisonment and fine.

I Agree *

Additional Details

Applied to the Office*

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