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Name
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Address
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Mobile No
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Email id
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Name of the District
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Name of the Block
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Name of the Panchayat
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Name of the Habitation
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MM Reference Number (Mudhalvarin Mugavari)
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Grievance type
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Grievance sub type
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Complaint Description
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Details of Complaint (Typed/Uploaded as scanned Document)
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PhotosÂ
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