PARLIAMENTARY ELECTION 2019 (ASSAM)

11 NO. KALIABOR PARLIAMENTARY CONSTITUENCY

CONTROL UNIT NO:………………………………………….
BALLOT UNIT NO……………………………………………...
VVPAT NO………………………………………………………..
1. BLIND AND INFIRM VOTERS:
i) USED BRAILLE: 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20
ii) BLIND VOTERS WITH COMPANIONS:
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20
iii) TOTAL BLIND VOTERS (I + ii): ………………………………
iv) INFIRM VOTERS WITH COMPANIONS:
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20
v) TOTAL BLIND AND INFIRM VOTERS: ………………….
2. NO. OF CHALLENGED VOTES: 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20
3. NO OF PROXY VOTES: 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20
4. NO. OF OVERSEAS VOTERS: 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20
5. NO. OF TENDERED VOTES: 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20
6. RECORD OF VOTES:

TIME MALE % FEMALE % TOTAL %

07 TO 09 AM
09 TO 11 AM
11 TO 01 PM
01 TO 03 PM
03 TO 05 PM
05 TO PM

7. REFUSED TO VOTE (49 O) IF ANY: 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20

Sl. No. Sl. No. in 17 A Sl. No. IN MARKED COPY NAME OF VOTER
8. NOT ALLOWED TO VOTE (49 M) IF ANY: 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20

Sl. No. Sl. No. in 17 A Sl. No. IN MARKED COPY NAME OF VOTER

9. TEST VOTES (49 MA) IF ANY: 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20

Sl. No. Sl. No. IN Sl. No. Of NAME OF No. Of TOTAL

in 17 A MARKED COPY CANDIDATE CANDIDATE VOTES CAST VOTES CAST

10. (i) TOTAL ASSIGNED ASD VOTERS: ………………..

(ii) TOTAL ASD VOTERS WHO VOTED: ……………….

ABSENT SHIFTED DUPLICATE

TOTAL HAVING VOTED TOTAL HAVING VOTED TOTAL HAVING VOTED

11. NO. OF VOTER SLIPS/QUEUE SLIPS ISSUED AFTER 5 PM:

12. TOTAL NO OF VOTERS VOTING WITHOUT EPIC: ………….
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66
67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97
98 99 100
13. Sl. No. of Green Paper Seal Used: ……………………………..
14. Sl. No. of Strip Seal Used: ……………………………..
15. Sl. No. of Pink Paper Seal Used: ……………………………..
16. Sl. No. of Special Tag Used: ……………………………..
17. Mock Poll Tabulation Sheet:-

Sl.No Name of the Candidate Name of the Vote cast Total

Party
1 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10

2 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10

3 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10
4 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10

5 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10

6 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10

7 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10

8 NOTA 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10

TOTAL VOTES CAST

18. TOTAL ASSIGNED VOTERS: ……………………………….

19. TOTAL VOTERS AS PER MARKED COPY OF ELCTORAL ROLL: …………………………
MALE: ……………… FEMALE: ……………………. TOTAL: ………………….
20. TOTAL VOTERS AS PER REGISTER OF VOTERS (17 A): ………………………
21. TOTAL VOTES AS PER VOTING MACHINE: ……………………..
22. TOTAL VOTERS VOTING WITHOUT EPIC: ……………………….
23. TOTAL VOTERS VOTING WITH EPIC: ………………………………