Name of Complainant* Father's Name*

Registration Number* Session*

Program Name* Semester*

Date Of Birth* Sex (M/F)*

Mobile Number* Email Id*

ID Proof* ID Proof Number*

Upload ID Proof (.jpg/.png/.jpeg file only max size 150kb.)* Address*

Tehsil* District*

State* Pin Code*

Nature of Grievance*

Details of the Complaint*

Upload the Complaint Application (If Any) (.pdf,.jpg/.png/.jpeg file only max size 2MB.)

Whether such complaint is made on CM Window *

Give Complaint Number And Date