Request Food

Tell us about your food requirement. Our team will verify and respond.

Your Name

Mobile Number

Location

Block

GP / Municipality

Area / Village

Detailed Address

Number of Family Members

Number of Children

Quantity

Food Requirement

Urgency

Description

Reason / Requirement

Additional Remarks

Attachment

Photo / Supporting Document

I confirm the details above are true and I consent to being contacted by the MLA's Office about this submission.

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Your privacy

Your mobile number, email and address are never shown publicly. Our team verifies each submission and only shares your contact details after a connection is approved.