Road Safety Call Center
New Ticket (* are Mandatory)
Complainant Detail
Mobile #*  
  OR
Land Line #
(91+STD code+Land Line Number)
Name *  
Plot/Flat # Colony/Building Name
Area/Locality Landmark (if any)
City State
PIN Code Email Id  
Complaint Detail
Category  
Complaint Area
Complaint Detail
Notifications    
Site/ Location Photo
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