104 Helpline Services Manipur
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Name/ মীং/
miH
*
Mobile/ মোবাইল নম্বর/
mobaIL nMbr
*
Invalid Mobile no.
Address/ লৈফম/
lEfM
*
Age/ চহী/
chi
--Select--
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Gender/ নুপা নুপী/
nupa/nupi
Male
Female
Others
Aadhaar /আধার /
AaDar
*
Invalid Aadhaar no.
District/ দীসত্রীক্ত/
Dist_rik_t
--Select--
Imphal West
Imphal East
Thoubal
Bishnupur
Senapati
Ukhrul
Chandel
Churchandpur
Tamelong
Jiribam
Kangpokpi
Kakching
Teknoupal
Kamjong
Noney
Pherzawl
Please write your concerns/ /অদোমনা খংবীনিংবা হাইবীনিংবাসিং অদু ইবীয়ু/
AdoMna KqbiniHba/haIbiniHbasiH Adu Iyu:
*
Enter the Text in the Picture/ মখাদা পরিবা ময়েকশিং অসি নমবীয়ু/
mKada pirib myeQsiH Asi nMbiyu: