Chief Minister Welfare Portal

Registration form

Name of Applicant:*

Gender*

Date of Birth*

Aadhar No. (12 digits)*

Mobile Number (10 digits)*

House No.*

Waddo/ Street*

Village Panchayat/ Municipality*

City/ Town/ Village*

District*

Taluka*

Assembly/Constituency*

Pincode

Email ID

Password*

Confirm Password*