Nominee's Information
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Full Name *
Date of Birth
MM
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DD
/
YYYY
Gender *
Telephone/Mobile Number
Email Address
Permanent Address
Province No. *
District *
Sub/Metropolitan City/Rural/Municipality
Name and Address of Current Office
Sector
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Designation
Office Contact Number
Date of Joining Office
MM
/
DD
/
YYYY
Years Remaining for Retirement
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