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ganganagar.raj.nic.in Open in urlscan Pro
164.100.153.57  Public Scan

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URL: https://ganganagar.raj.nic.in/leave/apply
Submission: On December 16 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

POST https://ganganagar.raj.nic.in/leave/apply

<form action="https://ganganagar.raj.nic.in/leave/apply" method="post" enctype="multipart/form-data" autocomplete="off">
  <input type="hidden" name="_token" value="H0CxpgSYl41i6wsUMDa26XLPACgjcDSgGdh3R9eG">
  <div class="w-full md:max-w-4xl mx-auto drop-shadow-xl p-0 transition-colors duration-500">
    <p class="py-4 text-xl font-bold uppercase text-center">Leave Application</p>
    <p class="py-1 text-center">Already applied? <a href="https://ganganagar.raj.nic.in/leave/status" class="btn btn-accent btn-sm">Check Status</a></p>
    <div class="px-5 grid grid-cols-1 md:grid-cols-2 gap-5">
      <div class="md:col-span-2 flex flex-col">
        <label for="emp_name" class="label">Employee Name</label>
        <input type="text" name="emp_name" id="emp_name" placeholder="Employee Name" class="input input-bordered capitalize" value="" maxlength="100" required="">
      </div>
      <div class="md:col-span-2 grid grid-cols-3 gap-5">
        <div class="form-control">
          <label for="gender" class="label">Gender</label>
          <select type="text" name="gender" id="gender" class="select select-bordered">
            <option value="" selected="" disabled="">-Select Gender-</option>
            <option value="M">Male | पुरुष</option>
            <option value="F">Female | महिला</option>
            <option value="T">Transgender | ट्रांसजेंडर</option>
          </select>
        </div>
        <div class="form-control">
          <label for="emp_code" class="label">Employee Code/Id</label>
          <input type="text" name="emp_code" id="emp_code" placeholder="rjgaxxxxxxxxxxxx" class="input input-bordered uppercase" maxlength="30" value="">
        </div>
        <div class="form-control">
          <label for="designation" class="label">Designation</label>
          <input type="text" name="designation" id="designation" placeholder="Designation" value="" required="" class="input input-bordered capitalize">
        </div>
      </div>
      <div class="md:col-span-2 flex flex-col">
        <label for="office" class="label">Office Name</label>
        <input type="text" name="office" id="office" placeholder="Office Name" class="input input-bordered capitalize" value="" max="255" required="">
      </div>
      <div class="form-control">
        <label for="mobile" class="label">Mobile Number</label>
        <input type="text" name="mobile" id="mobile" placeholder="9xxxxxxxxx" class="input input-bordered" value="" required="" minlength="10" maxlength="10">
      </div>
      <div class="form-control">
        <label for="alternate_mobile" class="label">Alternate Mobile Number</label>
        <input type="text" name="alternate_mobile" id="alternate_mobile" placeholder="9xxxxxxxxx" value="" minlength="10" maxlength="10" class="input input-bordered">
      </div>
      <div class="form-control">
        <label for="email" class="label">Email</label>
        <input type="email" name="email" id="email" placeholder="email@example.com" value="" class="input input-bordered lowercase">
      </div>
      <div class="form-control">
        <label for="election_duty" class="label">Election Duty?</label>
        <select name="election_duty" id="election_duty" placeholder="" class="select select-bordered" required="">
          <option value="" selected="" disabled="">-Select-</option>
          <option value="Y">Yes</option>
          <option value="N">No</option>
        </select>
      </div>
      <div class="hidden md:col-span-2 grid-cols-1 md:grid-cols-3 gap-5" id="election_duty_details">
        <div class="form-control">
          <label for="election_post" class="label">Election Post</label>
          <select name="election_post" id="election_post" class="select select-bordered">
            <option value="" selected="" disabled="">-Select Election Post-</option>
            <option value="PRO">PRO</option>
            <option value="PO1">PO1</option>
            <option value="PO2">PO2</option>
            <option value="PO3">PO3</option>
            <option value="MO">MO</option>
            <option value="WCO">WCO</option>
          </select>
        </div>
        <div class="form-control">
          <label for="employee_sr" class="label">Employee Serial No.</label>
          <input type="number" name="employee_sr" id="employee_sr" placeholder="xxxxx" class="input input-bordered" value="">
        </div>
        <div class="form-control">
          <label for="training_srno" class="label">Training Sr. No.</label>
          <input type="number" name="training_srno" id="training_srno" placeholder="xxxxx" class="input input-bordered" value="">
        </div>
      </div>
      <div class="form-control">
        <label for="start_date" class="label">Leave Start Date</label>
        <input type="date" name="start_date" id="start_date" placeholder="Leave Start Date" value="" class="input input-bordered" required="" min="2023-12-16">
      </div>
      <div class="form-control">
        <label for="end_date" class="label">Leave End Date</label>
        <input type="date" name="end_date" id="end_date" placeholder="Leave End Date" value="" class="input input-bordered" required="">
      </div>
      <div class="form-control">
        <label for="leave_type" class="label">Leave Type</label>
        <select name="leave_type" id="leave_type" placeholder="Leave Type" class="select select-bordered" required="">
          <option value="" selected="" disabled="">-Select Leave Type-</option>
          <option value="CL">Casual Leave | आकस्मिक अवकाश</option>
          <option value="PL">Privilege Leave | उपार्जित अवकाश</option>
          <option value="ML">Medical Leave | चिकित्सा अवकाश</option>
          <option value="PTL">Paternity Leave | पितृत्व अवकाश</option>
          <option value="MTL">Maternity Leave | मातृत्व अवकाश</option>
          <option value="CCL">Child Care Leave | बाल्य देखभाल अवकाश </option>
          <option value="EOL">Extra Ordinary Leave | असाधारण/अवैतनिक अवकाश </option>
          <option value="HPL">Half Pay Leave | अर्द्धवेतन अवकाश</option>
          <option value="Other">Other | अन्य</option>
        </select>
      </div>
      <div class="form-control">
        <label for="hq_leave" class="label">Leaving Headquarter?</label>
        <select name="hq_leave" id="hq_leave" placeholder="" class="select select-bordered" required="">
          <option value="" selected="" disabled="">-Select-</option>
          <option value="Y">Yes</option>
          <option value="N">No</option>
        </select>
      </div>
      <div class="md:col-span-2 flex flex-col">
        <label for="description" class="label">Description</label>
        <textarea name="description" id="description" placeholder="Write here" class="textarea textarea-bordered" rows="5" required=""></textarea>
      </div>
      <div class="form-control">
        <label for="document" class="label">Upload Document</label>
        <input type="file" name="document" id="document" placeholder="Upload document" class="file-input file-input-bordered" accept="application/pdf,image/png,image/jpg,image/jpeg">
        <span class="text-xs text-slate-600"> (Single PDF file or Image (JPG, PNG) maximum size upto 5 MB) </span>
      </div>
      <div class="form-control">
        <label for="captcha" class="label"><span>Enter Captcha</span>
          <button type="button" class="label-text-alt" id="reload-captcha-image"><i class="fa-solid fa-refresh"></i> Reload Captcha</button></label>
        <div class="grid grid-cols-2 gap-2">
          <img src="https://ganganagar.raj.nic.in/captcha/flat?KySlc7yD" id="captcha-image" alt="Captcha Image" class="rounded-lg">
          <input type="captcha" name="captcha" id="captcha" placeholder="Captcha Here" class="input input-bordered">
        </div>
        <link rel="modulepreload" href="https://ganganagar.raj.nic.in/build/assets/captcha-a6ab6be8.js">
        <script type="module" src="https://ganganagar.raj.nic.in/build/assets/captcha-a6ab6be8.js"></script>
      </div>
    </div>
    <div class="p-5 flex items-end justify-end">
      <button type="submit" name="submit" value="submit" class="btn btn-primary"><i class="fa-solid fa-save"></i> Submit</button>
    </div>
  </div>
</form>

Text Content

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महत्वपूर्ण सूचना | IMPORTANT INFORMATION

वर्तमान में इस एप्लीकेशन के माध्यम से केवल जिला श्रीगंगानगर (राजस्थान) में
पदस्थापित कार्मिकों के आवेदन ही स्वीकृत किए जा रहे हैं।

At present, through this application only the applications of the personnel
posted in district Sriganganagar (Rajasthan) are being accepted.

समझ गया/गई, जारी रखें | I understand, Continue

Leave Application

Already applied? Check Status

Employee Name
Gender -Select Gender- Male | पुरुष Female | महिला Transgender | ट्रांसजेंडर
Employee Code/Id
Designation
Office Name
Mobile Number
Alternate Mobile Number
Email
Election Duty? -Select- Yes No
Election Post -Select Election Post- PRO PO1 PO2 PO3 MO WCO
Employee Serial No.
Training Sr. No.
Leave Start Date
Leave End Date
Leave Type -Select Leave Type- Casual Leave | आकस्मिक अवकाश Privilege Leave |
उपार्जित अवकाश Medical Leave | चिकित्सा अवकाश Paternity Leave | पितृत्व अवकाश
Maternity Leave | मातृत्व अवकाश Child Care Leave | बाल्य देखभाल अवकाश Extra
Ordinary Leave | असाधारण/अवैतनिक अवकाश Half Pay Leave | अर्द्धवेतन अवकाश Other |
अन्य
Leaving Headquarter? -Select- Yes No
Description
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Rajasthan

Content provided by: District Election Officer, Sri Ganganagar

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