Commissionerate of Health Services, Public Health Department Maharashtra State

Group C Print Form

Notification Details

Applicant ID 1001280180

Candidate Personal Details

First Name POOJA Middle Name NIVRUTTI

Last Name BHANGARE Father's Name NIVRUTTI VITHOBA BHANGARE

Mother's Name RANJANA NIVRUTTI BHANGARE Date Of Birth 08/04/1996

Gender FEMALE Mobile No. 8975255802

Email ID [email protected] Nationality INDIAN

Domicile of Maharashtra Yes Marital Status UNMARRIED

No. of Children Name Change Status No

Changed First Name Changed Middle Name

Changed Last Name Aadhar No./Aadhar Enrolment No 425685027586

Category ST

Candidate Other Details

Marathi Language Proficiency Read Write Speak

Whether liable to be disqualified for the Government Services according to the provisions of Maharashtra Civil Service No
(Declaration of Small Family) Rules 2005?

Do you have Caste Certificate? Yes Caste Certificate Number SDO2352009

Place of Issue Ahmednagar Date Of Issue 01-07-2009

Do you have Non-Creamy Layer certificate obtained before the last date of advertisement? No

Date of Issue Valid Till

NCL Certificate Number Place of Issue

EWS Certificate as per GAD GR dated 12/02/2019 No

Do you want to avail the benefits of female Reservation? No

Place of Issue Date of Issue

Person with Disability No Do you have Disability Certificate (Minimum 40%) No

through (SADM, Software for Assessment of disability)?

Disability Type

Additional Disability Conditions 1 Additional Disability Conditions 2

दिव्‍यांग व्‍यक्‍ती (समान संधी) संपूर्ण सहभाग व हक्‍कांचे संरक्षण अधिनियम,१९९५ अन्‍वये दिले ली Manually स्‍वरुपातील दिव्‍यांगत्‍व प्रमाणपत्रे व No
SADM या संगणकीय प्रणाली अन्‍वये देण्‍यात आले ली>

Do you want Scribe/Writer for written No Do you want compensatary time for examination? No
exammination

Are you Orphan as per Women and Child Development Department's Government Resolution dated 2nd April 2018 GR No

Is Orphan cetificate issued by Women & No Orphan Certificate Number

Child Welfare Department?

Orphan Certificate Date of Issue Orphan Certificate Place of Issue

Project Affected or Dependent on Project No Project Affected Certificate Number

Affected dated 4 November 2016

Project Affected Certificate Date of Issue Project Affected Certificate Place of Issue

Earthquake Affected (Whether death of any family member or the house collapsed in the earthquake has been rebuilt No
by the Government dated 4th November 2016)

Earthquake Affected Certificate Number Earthquake Affected Certificate Date of Issue

Earthquake Affected Certificate Place of
Issue

Are you Anshkalin (Part-time Employee) (As per reference GR dated 27th October 2009, 19th September 2013) No

Name of Office Appointing Authority

Part Time Experience in Years Part Time Experience in Months

Part time Experience in Days

Do you have MSCIT certificate or equivalent certifiate? Yes

MSCIT Certificate Date of Issue 03-10-2012 MSCIT Certificate Place of Issue Bambavade

Are You Son/daughter/wife of a Suicidal No Date of Death Ceritficate

Farmer?

Are you an Ex-Serviceman? No Years of Service

Retired Ex-Serviceman No Are you Differently-abled Ex-Serviceman? No

Are you Government/Semi-Government No Name of Office/ Department

employee?

Type of Office Joining Date

End Date No. of Years

Are you Sports Man / Women & Qualify conditions mentioned per GR. Dated 01 July 2016 No

Sports Certificate Number Mention Date of Issue No

Are all sport certificates verified by No

director/deputy director?

Choice of Exam Centre Kolhapur

Address Details

Current Address Permanent Address

Address Line 1 Near Mahadev Mandir Bambavade Address Line 1 Near Mahadev Mandir Bambavade

Address Line 2 At Post Bambavde Address Line 2 At Post Bambavde

Village/Taluka Taluka Shahuwadi Village/Taluka Taluka Shahuwadi

State MAHARASHTRA State MAHARASHTRA

City KOLHAPUR City KOLHAPUR

Pincode 416213 Pincode 416213

Qualification Details

Educational Board/University Name of Subject Grade / Passing Marks Maximum Percentage/CGPA

Qualification Name Degree Marks Year Obtained Marks

SSC Kolhapur Marathi Marathi Marks 2012 481 550 87.45

HSC Kolhapur Science English Marks 2014 397 650 61.08

Graduate Shivaji University BSc Chemistry Marks 2017 1488 2500 59.52
Kolhapur

Post Graduate Shivaji University MSc Analytical Marks 2020 1664 2400 69.33
Kolhapur Chemistry

Experience Details

Name of Office Appointing Authority From To Duration

Payment Details

Payment Mode Transaction ID Date Amount Paid

DEBIT CARD NH100128018008060249 18 Aug 2021 430.00

Post Details

Post Name Post Type District

रासायनिक सहाय्‍यक Chemical Assistant Bureau Dy.Director of Health Service SPHL Pune