Candidate Registration

Name of the Post * :
Name of the Candidate * :


Father's / Husband's Name * :

   
Nationality * :
   
Aadhaar No * :
   
Permanent address with Pincode * :
(Attach address proof Certificate)
Postal address for Communication with Pincode: * :


 
Contact No * :
   
Email ID * :
   
Date of Birth (DD-MM-YYYY) * :
   
Gender * :
   
Caste * :

 (If belongs to SC/ST attach certificate)
 
Marital Status * :
 
Physical Handicapped * :
Percentage(%)
Disability Type
Currently Employed * :
Office Name

 NOC Received
Registration No * :

  (Only for the Post of Medical Officer, Nurse, ANM, Pharmacist)
Name of Registration Council * :

 
Work Experience :

  (If any upload your Experience Certificate)
Technical Experience :

  (If any upload your Technical Experience Certificate)

Educational Qualification
Name of the Examination University / Board / Institution Year of Passing Percentage of Marks obtained


Important:    Before "Save & Next" please ensure that all the details are correctly filled. After "Save & Next" details can not be edited.

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