Ballot results for the candidate by precinct
| Candidate | Szczygielska Dorota |
| Age | 41 |
| Address and endorsements | Węgrów , endorsed by Samoobronę Rzeczpospolitej Polskiej |
| Constituency no. | 4 |
| Number of votes for the candidate | 51 |
| % of valid votes for the candidate | 5.29% |
| Number of votes for the list | 0 |
| % of votes for the candidate relating to votes for the list | — |
| Mandate | No |
m. Węgrów
| No. | Address | Number of votes | % of valid votes* | Number of votes for the list | % of votes for the candidate relating to votes for the list * |
|---|---|---|---|---|---|
| 4 | Szkoła Podstawowa, ul.Kościuszki 16 | 51 |
5.30% 
|
73 |
69.86%
|
| 6 | Szpital Powiatowy w Węgrowie, ul.Kościuszki 201 | 0 | — | 0 | — |