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Biodata Form16062020

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abirabirabir0004
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82 views2 pages

Biodata Form16062020

Uploaded by

abirabirabir0004
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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BIO DATA

1. Name of the Post, applied for : ______________________________________


2. Name of the Project : ________________________________________
________________________________________
3. Name in full (IN BLOCK LETTERS): ________________________________________
(Name) (Surname)
4. Father’s /Husband Name : __________________________________________

5. Tel./Mobile No. : _____________________________

6. Email ID : _____________________________
7. Address for Correspondence : ________________________________________________________
________________________________________________________

8. Permanent Address : ________________________________________________________


________________________________________________________
9. Date of Birth : __________________ Age : _________
10. Whether SC/ST/OBC/General : __________________ Caste : ___________
11. Marital Status : Married / Unmarried
12. Educational Qualifications : _________________________________
Year of
Sr.No. Exam. Passed Grade Board / University Special Subjects
Passing

13. Work experience :


Period Post held &
Sr.No. Name of the Employer Reasons for leaving
From To Scale of
Pay

14. Employment Exchange Registration details, if available : No. ___________ Exchange ______________
15. If selected what period would you require to join the post : __________________________________
16. Have you ever been declared unfit by a Medical Board/Court Yes / No.
for appointment in any Govt. Service? (If yes, details) __________________________________
17. I came to know of this job opportunity from NIRRH Website/Other__________________________
(tick one and specify details for other).

Cont…2
-2-

19 Name of two responsible person 1)


of your locality or two references Name : _______________________________________
to whom you are known:-
Address: ___________________________________________
___________________________________________________
___________________________________________________
E-mail : ____________________________________________
Contact No./ Mobile No. ______________________________
2)
Name : _______________________________________
Address: ___________________________________________
___________________________________________________
___________________________________________________
E-mail : ____________________________________________
Contact No./ Mobile No. ______________________________

Declaration
I hereby declare that the information furnished above is true, complete and correct to the best
of my knowledge and belief. I understand that in the event of my information being found false
or incorrect at any stage, my candidature/ appointment shall be liable to cancellation /
termination without notice or any compensation in lieu thereof.

Date : _______________
Place : _______________

Signature of the Candidate

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