RTPS Assam

Grievance Registration Form All Fields marked with * are mandatory

Personal and Communication Details

Mobile Number *

Verify

Provide Mobile number in order to receive SMS alerts related to your grievance

Name *

Gender *

Male

Female

Others

Country *

State *

District *

Address 1*

Address 2

Address 3

Pincode *

Email ID

Grievance Details

Grievance Category *

Name of the Service Applied *

Grievance Description * Maximum 4000 characters are allowed in description (4000 Remaining )

Attach relevant/Supporting Documents (if any)

Only PDF file upto 2 MB allowed.

Declaration

I hereby state that the fact mentioned above are true to the best of my knowledge and belief.

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