Incidence Form for Incident Happen in Kharagpur Workshop - Complaint

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NIRBHAYA

South Eastern Railway
Sexual Harassment at Workplace
Complaint Management System

Incidence Form to register a harassment incidence in Kharagpur Workshop 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: *

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