Post Name *  :  

Candidate Name *  :  

Father/Husband Name *  :  

Mother Name *  :  

Nationality *  :  

Date Of Birth *  :  

Age   :  

Years

Months

* Cut off date 01 January 2019

ID Document Type *  :  

ID Document No. *  :  

Marital Status *  :  

Gender *  :  

Domicile Of Bihar *  :  

Reservation Category *  :  

Physically Disabled *  :  

Have any work experience *  :  

Registration done(doctors only, if applicable) *  :  

Registration Type *  :  

Registration Date *  :  

Registration Number *  :  

Contact Details

Phone Number (With STD Code)   :  

Mobile Number *  :  

Alternate Mobile Number  :  

E-mail ID *  :  

 
 

Correspondence Address

Address *  :  

State *  :  

District *  :  

Pincode *  :  

Permanent Address

Address *  :  

State *  :  

District *  :  

Pincode *  :  

 
 

Basic Qualification

Degree Stream/Course Subject/Specialization School/College/Institute Board/University Passing Out Year Result Type Total Marks Obtained Marks/CGPA Marks (%) Award (if any)
 
 

Working Experience (Enter experience from current to previous)Add New Row

Sl.No. Department / Organisation Post Name Post Type Type of Employer State District Place Of Posting Start Date End Date
1
 
 

Languages Known Add New Row

No. Language Read Write Speak
1
2

Retirement Details (if worked in government sector)

Retired *  :  

References   :  

Sl. No. Name of Person Organisation Name (if any) Designation (if any) How do you know this person Contact No. Email ID
1
2

Photo & Singnature

Photograph Image: JPG or JPEG or PNG format only

  • Size of file should be between 20kb–100 kb.

Signature Image: JPG or JPEG or PNG format only

  • Size of file should be between 10kb – 100kb.

Photo *  :  

Signature *  :  

Negative Case Proceeding


Kindly check on declaration for final submission