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Last Date For Receiving of Application On 08.11.2024 To 12.11.2024 5.00 PM

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devenderk786
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22 views3 pages

Last Date For Receiving of Application On 08.11.2024 To 12.11.2024 5.00 PM

Uploaded by

devenderk786
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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Application for the post of …………………………………..

in Mancherial District

Last date for Receiving of Application on 08.11.2024 to 12.11.2024 5.00 PM

1 Name of the Candidate

2 Name of the Father

3 Name of the Mother Paste Photograph here


and sign across by self
4 Name of the Husband attestation

5 Gender

6 Date of Birth

OC BC-A BC-B BC-C BC-D BC-E SC ST EWS


Social Status (Please
7
tick)

Whether Physically
Yes No
8 handicapped (Please
tick)
HH OH VH

Whether Ex-
9 Servicemen/Woman Yes No
(Please tick)

Details of School Education: -


Class Year of Regular/Private Name of the School District of the
Education School
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th

District to which candidate belongs to as per Presidential order:

Details of Qualifying Examination: -


Course Year of Year of Name of the Name of the
Education Passing College&District University

Details of Registration of Qualifying Exam: -


Registration No Registration Date Name of the Council Where
Registered

Details of Marks in Qualifying Exam: -


Consolidated Total Marks of Marks obtained by the Percentage (%)
the Exam Candidate Obtained/Grade Obtained

Details of Application Fee Paid (Rs. ------ per Candidate)


(Payable in the form of Demand Draft drawn on --------------------------------------District)

Demand Draft No. D.D. Date Name of the Bank & Branch

ADDRESS PARTICULARS:
Name :
Father/Husband Name :
House No. :
Street :
Village/Town :
District :
Pin :
Contact No. :
Check List:
1 S.S.C or Equivalent examination.
Intermediate or 10 + 2 examination.
3 Qualifying Examination Pass Certificate.
4 Marks Memos of all the years (qualifying examination)
5 Registration Certificates of respective Councils
6 Latest Caste Certificate issued by the Tahsildhar/MRO concerned

7 Study certificate for the years from 1th class to 10t" class and in Case of
Private study residence certificate from the Tahsildhar/MRO concerned.

8 PH certificate in respect of candidates claiming reservation under PH Quota.

9 Relevant certificates in respect of candidates claiming Ex-service Men


Quota.
10 1 Photograph duly pasted on the application form.
11 Acknowledgement Card.
DISTRICT MEDICAL AND HEALTH OFFICER: : MANCHERIAL
ACKNOWLEGEMENT TO CANDIDATE

Application No.

Application for the post of ………………………………. on Contract/Outsourcing

basis, Received from

Kum/Smt……………………………………………………………………………………….

D/o, W/o. …………………………………………. R/o …………………………………….

Date: Signature of the


Receiving Employee

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