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    APPLICATION PRINT

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    APPLICATION PRINT

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    72 views2 pages

    App Print

    Uploaded by

    PRS CREATIONS
    APPLICATION PRINT

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    7/23/2019 online.bih.nic.in/LSRec/APP/AppPrint.

    aspx

    Application Form
    Social Welfare Department (ICDS), Govt. of Bihar
    Application for Contractual Recruitment of Lady Supervisor
    Application Details
    Application ID : LSP/0294648 Application Date :
    Post Applied For : Lady Supervisor
    23-Jul-2019

    Personal Details
    Applicant Name MINTA KUMARI
    Father's /Husband's Name SURESH KUMAR YADAV
    Mother's Name CHHATHIYA DEVI
    Date of Birth 04-Jun-1994
    Age as on (01.01.2019) 24 Years 6 Months
    Gender Female
    Marital Status Yes
    Category BC
    Nationality Indian
    Physically Handicapped No
    Catagory of Physically Handicapped
    Percentage of Physically Handicapped No
    Grand Children of Freedom Fighter No
    Email ID [email protected]
    Mobile No. 9708188503
    Phone With STD Code
    Aadhar No XXXXXXXX9608
    Identification Marks A MOLE ON THE NECK
    Do you know read/write hindi Yes
    Do you have minimum qualification as Yes
    defined in Advertiesment
    Reference of known person with address
    who has seen Your Work [Last Six
    Month] (1)
    Reference of known person with address
    who has seen Your Work [Last Six
    Month] (2)
    If any Criminal Proceedings[Aapradhik No
    Mukadama] Against You has been
    Initiated ?
    Are you Employee of Bihar Govenment No
    Designation
    Office
    Place

    Address for Correspondence


    Address VPO-HARIHANS PS-HUSSAINGANJ DIST-SIWAN BIHAR
    Pin Code 841286

    Permanent Address
    Address VPO-HARIHANS PS-HUSSAINGANJ DIST-SIWAN BIHAR
    Pin Code 841286
    State of Domicile Yes

    online.bih.nic.in/LSRec/APP/AppPrint.aspx 1/2
    7/23/2019 online.bih.nic.in/LSRec/APP/AppPrint.aspx
    Home District SIWAN

    Educational Qualification
    Board/University Institute State Specialization Passing Marks
    Type Year Obtained
    (%)
    I.Matric B.S.E.B. PATNA Gevernment Bihar 2009 42.4
    II.Intermediate B.S.E.B. PATNA Gevernment Bihar Arts 2011 49.2
    III.Degree JAI PRAKASHVISHWAVIDYALAYA (UNIVERSITY) Gevernment Bihar Psychology 2014 63.37
    CHAPRA
    IV.Post Private 0 0
    Graduation

    Experience
    No Experience Mentioned

    Points
    Total Point 56.66

    I declare that all the above information is correct to the best of my knowledge and that I shall be liable for punishment if information is found
    incorrect. I also declare that I have understood the guideline for engagement and will fully abide by the same including any further guideline issued
    by ICDS, Government of Bihar in this regard. I categorically declare that there is no pending Criminal case or serious complaint against myself.

    Place:-

    Date:-
    Signature of Applicant

    online.bih.nic.in/LSRec/APP/AppPrint.aspx 2/2

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