Complaint & Grievance Form form1 Name * Name First Name First Name Last Name Last Name Phone * Email * Select Cities * BalasoreSoroNilagiriJaleswarBhograiBastaRemunaKhantapadaSimuliaOupada Select issues * Road & Street ProblemsStreet LightsWater SupplyGarbage & SanitationDrainage & SewerageHealth ServicesEducationTransportParks & Public SpacesElectricity Message * Submit If you are human, leave this field blank. Citizen Feedback form2 Name * Name First Name First Name Last Name Last Name Phone * Email * Message * Feedback * β ββ βββ ββββ βββββ Submit If you are human, leave this field blank. β Citizen Poll Your opinion matters. Tell us about the services and issues in your city and help us improve Baleshwar District. π Select Your City / Town * Select City / Town Balasore (Baleshwar) Soro Jaleswar Nilagiri Remuna Basta Bhograi Simulia Bahanaga Oupada Khantapada Kamarda Chandipur π What issue would you like to rate? * π£οΈ Roads & Streets π§ Water Supply ποΈ Garbage & Sanitation π° Drainage π‘ Street Lights π₯ Health Services π Transport β‘ Electricity π¨ Public Safety β How would you rate this service? * β β β β β π¬ Your Feedback * Submit Your Feedback β Thank you! Your feedback has been submitted.