Bihar Driving License Application form

DERIVING LICENSE APPLIKASON PHOROM

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NOTE: Please do not soot the person at the applikason kounter.

He will give you the licen.

If you dot know how to fill ,copy from your phriend (dost)applikason.

For phurthar instructions, see bottom applikason.

1. Last name:

(_) Yadav (_) Sinha (_) Pandey (_) Misra (_) Dont no

(Check karet box)

2. phust name:

(_) Ramprasad (_) Lakhan (_) Sivprasad (_) Jamnaprasad (_) Dont no

(Check karet box)

3. Age:

(_) Less than phipty (_) Greater than phipty (_) Dont no

(Check karet box)

4. Sex: ____ M _____(F) _____ not sure _____not applicable

5. Chappal Size: ____ Lepht ____ Right

6.Occupason:

(_) Politison (_) Doodhwala (_) Pehelwaan (_) House wife (_) Un-
employed

(Check karet box)

7. Number of children libing in the household: ___

8. Number that are yourj: ___

9. Mather name: ____________ _________ __

10. Phather Name: ____________ ________

11. Ejjucason: 1 2 3 4 (Circle highest kilass attended)

12. Dental rekard:

(_) Ellow (_) Berownish-ellow (_) Berown (_) Belack (_) Other -
__________ Give egjhakt color

(Check karet box)

13.Your thumb imparesson :

____________ _________ _______

(If you are copying from another applikason pharom, pleaje do not
copy thumb impression also. Pleaje

provide your own thumb impression.)

PELEAJE DO NOT USE PHINGERS OF YOUR LEGS

Use thumb on your lepht hand only. If you dont have lepht hand, use
your thumb on right hand.
NOTE: IF YOU DONT HAVE BOTH HANDS, YOU CANNOT DERIVE.
WE ARE VARY ISTRICT ABOUT THIS