जिल्ला गाउँ/नगरपालिका गाउँ/नगरपालिकाः गाउँ/नगरपालिकाः वडा नं टोल अभिभावकको नाम बालबालिकाको पुरा नाम
I used Google Translate on your post - what is your question?
Can you upload your XLSForm file? Have you looked at the documentation on https://xlsform.org/ ?
You can use text type to collect these kind of details.
Best,
Narendra