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Eastern Railway leave application form upto the rank of mistry. Department. Office 1.Applicant's name in full and designation. 2. The date of attending the age of 60 years. 3. Nature and period of leave applied for and date from which required. 4. Purpose for which leave is required. Note. If on medical grounds, medical certificate should be attached. 5. Address while on leave.

Date:.

Signature of applicant