DRIVING LICENSE APPLIKASON PHOROM
------------ --------- --------- --------- --------- --------- -----

NOTE: Please do not shoot the person at the applikason kounter. He will give you the licen. For phurthar instructions, see bottom applikason.

1. Last name:
(_) Yadav (_) Sinha (_) Pandey (_) Misra (_) Dot no (Check karet box)

2. First name:
(_) Ramprasad (_) Lakhan (_) Sivprasad (_) Jamnaprasad (_) Dot no (Check karet box)

3. Age:
(_) Less than phipty (_) Greater than phipty (_) Dot no (Check karet box)

4. Sex:
____ M _____ P(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 yours: ___
9. Mather name: ____________ _________ __
10. Phather Name: ____________ ________ (If not no,leave blank)
11. Ejjucason: 1 2 3 4 (Circle highest grade completed)

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, please do not copy thumb impression also. Please provide your own thumb impression.)
PELEASE 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. If you do not have right hand, use thumb on lepht hand.NOTE : IF YOU DONT HAVE BOTH HANDS, YOU CANNOT DRIVE.
WE ARE VARY ISTRICT ABOUT THIS