Municipal and government · Form

Sample Form: خوداظهاری کنتور آب/برق

مشترک شماره‌ی اشتراک، رقم کنتور و عکس آن را می‌فرستد.

5 questions · Free up to 50 responses a month

Print-ready Word and PDF files — free, no sign-up.

About this template

“خوداظهاری کنتور آب/برق” has 5 questions; every question is required. Question types: Short text (1), Mobile number (1), Number (1), Date (1), File upload (1).

In the online version of this template

  • Mobile numbers are validated against the Iranian number format.
  • Dates are picked and stored on the Jalali (Persian) calendar.
  • Attached files are stored with the response.

Questions in this template

  1. 1.

    شماره اشتراک *

    (Short text)
  2. 2.

    شماره موبایل *

    (Mobile number)
  3. 3.

    رقم کنتور *

    (Number)
  4. 4.

    تاریخ قرائت *

    (Date)
  5. 5.

    عکس کنتور *

    (File upload)

Printable version (Word & PDF)

  • For filling in on paper, signing and filing by hand
  • Edit the Word file any way you like
  • Collecting and typing up the answers is up to you

Online version on Porsino

  • Answers are collected and organised automatically — no retyping
  • National ID, mobile number and dates are validated instantly
  • Ready-made reports and charts, plus Excel export in one click
  • Share a link or QR code — it works on mobile too

How do I use this template?

  1. Sign up for Porsino for free; no bank card needed.
  2. In the panel, open “Templates” and choose “خوداظهاری کنتور آب/برق”.
  3. Change the questions as you like, publish the form and send the link.
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