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hmSI¡cmÀ
........................................................................................................................................................................ Xn¿Xn
..............................................................................Xmeq¡v,...................................................................... hntÃPv,
..............................................................................tZi¯v,........................................................................ ho«nÂ,
......................................................................aI³/`mcy/aIÄ............................................................ sXmgnÂ
...............................................................................hbÊv,..........................................................................................
F¶bmÄ (em³UvtemÀUv/sI«nS DSa) H¶mw ]mÀ«nbmbpw
H¶mw ]mÀ«n (sI«nS DSa) :
c−mw ]mÀ«n (hmSI¡mc³) :
2
..............................................................................Xmeq¡v,...................................................................... hntÃPv,
.............................................................................tZi¯v,........................................................................ ho«nÂ,
......................................................................aI³/`mcy/aIÄ............................................................ sXmgnÂ
...............................................................................hbÊv,..........................................................................................
F¶bmÄ (sSâv/hmSI¡mc³) c−mw ]mÀ«nbmbpw FgpXn h¨ hmSI¡cmÀ.
H¶mw ]mÀ«n (sI«nS DSa) :
c−mw ]mÀ«n (hmSI¡mc³) :
3
…………………………..................................………. {Kma]©mb¯v ]cn[nbn H¶mw
]mÀ«nbpsS DSaØXbnepw ssIhi¯nepw Ccn¡p¶Xmb ……………..… {¼v sI«nSw
…………..……… c−mw ]mÀ«nbpsS …..………....…………… Bhiy¯nv C¶papXÂ
………………………………...………................. amk Imemhp[n nÝbn¨pw k½Xn¨pw
{]Xnamkw …………………..........…………………………………………….. cq] hmSI
nÝbn¨v c−mw ]mÀ«n Ct¶ Znhkw H¶mw ]mÀ«ntbmSv hmSI¡v Gäv Sn sI«nS¯nsâ
Xmt¡m klnXw ssIhiw FSp¯ncn¡p¶p. c−mw ]mÀ«n H¶mw ]mÀ«n¡v ÂtI−
Xmb hmSI FÃm Cw¥ojv amk§fpsSbpw ……………….. Xn¿XnIfn sdm¡w ÂIn
AXmXv kabw cioXn hm§n sImÅmsa¶pw hmSI _m¡nsh¨m BbXnv acymZ
]eni Iq«n ÂIns¡mÅmsa¶pw nÝbn¨ncn¡p¶p. Sn hmSI¡p ]pdsa sI«nS¯nÂ
c−mw ]mÀ«n D]tbmKn¡p¶ CeIv{Snknän NmÀÖpw, AUojW NmÀÖv h¶mÂ
AXpw AXmXp kab§fn c−mw ]mÀ«n HSp¡n cioXn H¶mw ]mÀ«nsb t_m[ys¸Sp
t¯XmWv. sI«nS apdn¡p tZmjw hcmhp¶ coXnbnepÅ D¸v, Imcw, KÔIw, shSnacp¶v,
hfw apXemb km[§fpw kÀ¡mÀ, nbaw aqew ntcm[n¨ km[§fpw Sn sI«nS apdn
bn kq£n¡p¶Xsöpw c−mw ]mÀ«n k½Xn¨ncn¡p¶p. ta¸dª Bhiy¯nÃm
sX Sn sI«nSw c−mw ]mÀ«n aäp bmsXmcp Imcy§Ä¡pw D]tbmKn¡p¶Xsöpw sI«nS
¯nv C¶s¯ nebn bmsXmcphn[ {]IrX t`Z§fpw hcp¯p¶Xsöpw tamis¸
Sp¯p¶Xsöpw IogvhmSI¡v sImSp¡p¶Xsöpw Ay ssIhiw sImSp¡p¶XsÃ
¶pw Iã ã§Ä¡v CShcp¯p¶Xsöpw c−mw ]mÀ«n k½Xn¨ncn¡p¶p. BbXv
kw`hn¨m BbXnp−mIp¶ sNehpIÄ c−mw]mÀ«n ]¡Â n¶pw hkqem¡mhp¶
Xpw H¶mw ]mÀ«n¡v taÂS]SnIÄ sN¿m³ ]cn]qÀ® kzmX{´yapÅXpw c−mw ]mÀ
«nsb tm«okv IqSmsX Hgn¸n¡mhp¶Xpw BbXnp−mIp¶ sNehpIÄ c−mw ]mÀ«n
bn n¶pw hkqem¡mhp¶XpamIp¶p. Sn sI«nSw ta¸dª Imemhp[n¡v apt¼
c−mw ]mÀ«n¡v Hgnbp¶Xntm H¶mw ]mÀ«n¡v Hgn¸n¡p¶Xntm …….....................……
Znhks¯ ap³IqÀ tm«okv aXnbmIpsa¶pw nÝbn¨ncn¡p¶p.Sn IcmÀ Imemh[n Ign
ªm bmsXmcphn[ XÀ¡hpw IqSmsX c−mw ]mÀ«n Nnehn Sn sI«nSw Hgnªp sIm
Spt¡−XmWv. taÂ{]ImcaÃmsX c−mw ]mÀ«n Fs´¦nepw {]hÀ¯n¨v H¶mw ]mÀ«n¡v
Fs´¦nepw Iãã¯nnSbm¡nbmtem tImSXn aqew nhr¯nIÄ k¼mZnt¡−Xmbn
h¶mtem c−mw ]mÀ«n I¿nm nI¯n ÂtI−XmWv. Ct¶ Znhkw H¶mw ]mÀ«n
AUzm³kmbn ssI]Ánb ………….........……………………….…………………… cq]
c−mw ]mÀ«n hlIÄ hns«mgnªv ÂIp¶ kabw, H¶mw ]mÀ«n¡v Fs´¦nepw Iã
ã¯nnSbmbm BbXv Ign¨pw AÃm¯ ]£w apgph³ kwJybpw ]eni IqSmsX
Xncn¨p ÂtI−XmWv. taÂnÝbn¨ hmSIkwJy ymbamsW¶pw ImeØnXns¡m¯
XmsW¶pw Ccp ]mÀ«nIfpw k½Xn¨ncn¡p¶p. ……………………………………………
…………………………………..……………… taÂ{]ImcsaÃmw nÝbn¨pw k½Xn¨pw
Xmsg t]À FgpXn H¸nSp¶ km£nIÄ ImsW Ccp]mÀ«nIfpw H¸n«ncn¡p¶p.
H¶mw ]mÀ«n (sI«nS DSa) :
c−mw ]mÀ«n (hmSI¡mc³) :
km£nIÄ :
1.
2.
I¼yq«À {]nâv HgnsI FgpXnbXv:
sh«pXncp¯v :
H¶mw ]mÀ«n (sI«nS DSa) :
c−mw ]mÀ«n (hmSI¡mc³) :

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