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The document is an online application for the Odisha Civil Services Examination-2019. It contains the personal and academic details of the applicant, PALBAN PANDA. It lists his registration ID, Aadhar number, name, father's name, date of birth, category, academic qualifications, preferences for civil service posts, work experience, relation to OPSC staff and declaration. The medium of exam is English and his optional subjects are Anthropology and Geography.

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115 views2 pages

Form PDF

The document is an online application for the Odisha Civil Services Examination-2019. It contains the personal and academic details of the applicant, PALBAN PANDA. It lists his registration ID, Aadhar number, name, father's name, date of birth, category, academic qualifications, preferences for civil service posts, work experience, relation to OPSC staff and declaration. The medium of exam is English and his optional subjects are Anthropology and Geography.

Uploaded by

Plaban Panda
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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ODISHA PUBLIC SERVICE COMMISSION

Online Application for Odisha Civil Services Examination-2019 [Advt. No 11 of 2019-20](Zone:Bhubaneswar)


Optional Subjects in the Main Written Examination
Opt. Sub.- 1: ANTHROPOLOGY
Opt. Sub.- 2: GEOGRAPHY
Medium of Language to Answer the Questions in Main Written Examination: ENGLISH
1. Registration ID 111920109217
2. AADHAR No. 475295465961
3. Name of the Candidate PALBAN PANDA
4. Father's Name MEENA KETAN PANDA
5. Mother's Name JHULI PANDA
6. Category : UNRESERVED Subcaste : *********
Misc. Case No. : ******* Date : *******
7. Date of Birth : 05-MAR-1984 8. Ex-Service Man : No
9. Sports Person : No 10(a). PWD Category : No
10(b). Scribe Required : Not Applicable 10(c). Type of Disability : Not Applicable
11. Odia Test Passed: Yes 12. Religion : HINDU
13. Gender : Male 14. Nationality : INDIAN
15. Marital Status : MARRIED 16. Mother Tongue : ODIA
17. Present Mailing Address PLOT NO.-1089/2159/5611
ADARSHA VIHAR DUMUDUMA
BHUBANESWAR
KHORDHA
ODISHA - 751019
18. Permanent Address PLOT NO.-1089/2159/5611
ADARSHA VIHAR DUMUDUMA
BHUBANESWAR
KHORDHA
ODISHA - 751019
19. Mobile No. : 8900624175 20. E-Mail : [email protected]
21. Fee Amount : 500 22. Are You a Govt. Servant? : NO
23. No. of Attempts Already Made : 03 24. If Appeared at OCSE-2017 or OCSE-2018 ?YES

Photograph Signature Left Thumb Impression

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DATA SHEET OF REG. NO 111920109217
Online Application for for Odisha Civil Services Examination-2019 [Advt. No 11 of 2019-20](Zone:Bhubaneswar)

Academic Qualification

Academics Exam Passed Board/Council/ University Institution from which passed Maximum Marks Secured Marks Passing Year

10th Standard MATRICULATE CBSE DAV UNIT-VIII BBSR 500 373 1999

+2/12th Standard INTERMEDIATE(PCMB) CHSE BIJU PATTNAIK COLLEGE 1100 451 2001

Graduation BACHELOR OF ARTS MJPRU BAREILLY COLLEGE 1200 744 2009

Preference of Post / Service :

Preference -1 :Odisha Administrative Service Preference -2 :Odisha Finance Service

Preference -3 :Odisha Police Service Preference -4 :Odisha Reveune Service

Preference -5 :Odisha Co-operative Service Preference -6 :Odisha Taxation & Accounts Service

Experience

Name of Employer Designation From (Service) To (Service) Nature of Duty Reason for Leaving

Debaring from any post/service/examination by OPSC/any PSC/UPSC

Name of P.S.C. Name of POST/Service/Exam Year of Exam Period of Debarment

Relation, if any with any staff of the Commission

Name of the Staff Designation Relation

Declaration
I hereby declare that all statements made in this application are true, complete and correct to the best of my knowledge and
belief.In the event of information being found false or incorrect, or intelligibility being detected before or after the examination, action can
be taken against me by the Commission.
I PALBAN PANDA, Son of Sh. MEENA KETAN PANDA Aged 34 Years resident of District KHORDHA, ODISHA, hereby declare that the
information given above and in the enclosed documents is true to the best of my knowledge and belief and nothing has been concealed
therein. I am well aware of the fact that if the information given by me is proved false/not true, I will have to face the punishment as per the
law. Also, all the benefits availed by me shall be summarily withdrawn

Date :
Place :
Signature of the Candidate
(N.B: Application not signed by the candidate is liable to rejection)

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