APPLICATION FORM FOR PEST AND DISEASE CONTROL 1. Name : 2. Address : 3. Pest and diseases affected area : 4. Survey Number : 5. Ward Number : 6. Description on pest & diseases : Place : Dated : Signature of the Applicant. FOR OFFICE USE (After site inspection ) 1. Name of pests/diseases affected : 2. Total area affected : 3. Name of Pesticide/Fungicides used : 4. Quantity utilized : 5. Total area covered : 6. Name & Designation of the Officer : supervised. : 7. Remarks : Agrl. Officer/Agrl. Demonstrator/ Agrl. Supervisor
