PHC | Password Hashing Competition Submissions | Learning library

{% extends "pmmvyapp/base.html" %}
{% load crispy_forms_tags %}
{% load static %}
{% block content%}

  
  {% csrf_token %}
  
      
      Please Fill up the details below (Note that required field are marked by '*' )
    
    1.Beneficiary Details
    Does Beneficiary have an Adhaar Card?*
    Yes
    No
   
    
      
        Name of Beneficiary(as in Aadhar Card)*
        
      


      
        Aadhaar Number(Enclose copy of Aadhaar Card)*:
        
      
    
    
    

      
        Please provide any of the following Identity Card*:
        
          Bank or Post Office photo passbook
          Voter ID Card
          Ration Card
          Kishan Photo Passbook
          Passport
          Driving License
          PAN Card
          MGNREGS Job Card
          Her husband's Employee Photo Identity Card issued by the government
           or any Public Sector Undertaking
          Any other Photo Identity Card issued by State Government or Union Territory Administrations
          Certificate of Identity with photograph issued by a Gazetted Officer on Official letterhead
          Health Card issued by Primary Health Centre(PHC) or Government Hospital
          Any other document specified by the State Government or Union Territory Adminstration
        
        

        
          Aadhaar Enrollment ID(EID):

          
        


                
          Name of Beneficiary(as in Identity Card)* 
          
        


        
          Identity Number(Enclose Copy of Identity Card)*:

          
        
    
 


    Submit
  
   
{% endblock %}