Note : All red (*) marked fileds are required.
Name * Father's Name Mother's Name
Husband Name National ID Gender
Birth Date   Post Office*

Contact Address
House No Address
Mobile Number*   E-mail  

Description of Connection Place
House/DagNo* Plot No AV/LANE/Road No
Block Thana Section
Land Phone Area*
      If division is incorrect it will be corrected by DESCO at Division

Description of Connection/Additional Load
Connection Type * Load*
(in KW)
Phase Category *

     Image Format *.jpg & Max size 150KB

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Meter Information

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