Incidence Form for Incident Happen in Chakradharpur Division - Complaint

Incidence Form to register a harassment incidence in Chakradharpur Railway Jurisdiction

Your Full name *

Designation *

Address *

Division *

Place of posting *

Mobile no. *

Email if available

Incident Address *

Division under which above place lies *

Place at which harassment incident took place *

Date of incident *

Has Police complaint been lodged? *

Yes
No

Is the case in court? *

Yes
No

Name the person against whom the complaint is *

Designation of the person against whom the complaint is *

Division of posting of person against whom the complaint is *

Place of posting of the person against whom the complaint is *

Brief description of the incident: *