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State of Haryana - Section

Section 5 in The Punjab State Legislature Officers, Ministers and Members (Medical Facilities) Act, 1965

5. Any other relevant information.

Witnesses:Signature or left/right hand thumb impression.Note. - The descriptive roll (Column 4) and signatures or left/right hand thumb and fingers impressions accompanying application for family pension should be in duplicate (in two separate sheets) and attested by two gazetted officers or persons of respectability of the Village/Town/City in which the a applicant resides.Specimen signatures of Shri/Shrimati _____________________ widow/widower of late Shri/Shrimati __________________ who was serving as member.Attested.Descriptive roll of Shri/Shrimati ___________ widow/widower of late Shri/Shrimati ___________ who was serving as memberHeight __________________________Identification marks :-Attested.