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New Complaint
Note:- Fields marked with
(*)
are mandatory.
1. Personal Information
Mobile No.:
*
Name:
*
Email:
*
You Are:
*
Select
Wholesaler
Retailer
Manufacturer
Individual
Name of Establishment:
Address of Establishment:
*
State Name
*
Select State
ANDAMAN AND NICOBAR ISLANDS
ANDHRA PRADESH
ARUNACHAL PRADESH
ASSAM
BIHAR
CHANDIGARH
CHHATTISGARH
DELHI
GOA
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU AND KASHMIR
JHARKHAND
KARNATAKA
KERALA
LADAKH
LAKSHADWEEP
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
MIZORAM
NAGALAND
ODISHA
PUDUCHERRY
PUNJAB
RAJASTHAN
SIKKIM
TAMIL NADU
TELANGANA
THE DADRA AND NAGAR HAVELI AND DAMAN AND DIU
TRIPURA
UTTAR PRADESH
UTTARAKHAND
WEST BENGAL
Division Name
District Name
*
Tehsil / Area
2. Grievance Details
Grievance Type:
*
Select
Drugs and Cosmetics
Food
Grievance Against:
*
Select
Wholesaler
Retailer
Manufacturer
Name of Establishment :
Address of Establishment :
State Name
*
Select State
UTTARAKHAND
Division Name
*
District Name
*
Tehsil / Area
*
Complaint Subject / Attribute:
Your Complaint:
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1850
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