Grievance

Grievance Form

Grievance by*

*Others, kindly specify

Are You Enrolled under ABDM ?*

User/Entity Details

Name*

Organization Name*

Mobile Number*

State Of Employment*

State Of Employment

State*

District*

State*

District*

Address*

Grievance Details

Grievance Related To*

Grievance Description*

Char Left :3000

Note: Description length should be 3000 characters only

Upload Files

Upload Supporting Documents Note: Maximum of 04 documents upto 5mb each and should be of Png,jpeg,jpg,pdf,docx file format.