BIO – DATA for the Post of : __________________

( Below data's are correct as per my information & knowledge AND no more addition / deletion / alteration / modification Affix Photo
are required to be done from my side )
Date : _____________ (Please fill up in CAPITAL Letters) SOURCE : _________________________
NAME: E-mail ID: Mob. :
Blood Group Nationality : MARITAL Marriage (dd/mm/yyyy)
Date of Birth: SEX Male /
(Pls.Tick √ STATUS Y/N
dd/mm/yyyy Religion : ) Female
(Pls.Tick √)
PAN No Aadhar Ex-ESI.No: EPF No. EPF UAN.No

(Permanent)
ADDRESS
(Present)

NATIVE
PLACE
PIN: PIN:
PARENT'S DETAILS
TEL.No. Mob.No: Working Retired Pension
(With STD) If any Mob.

FATHER / HUSBAND’S NAME Y/N Y/N Y/N

AGE
'Y'
(I f m a r r i e d) (Pls. Tick) (Pls. Tick) (Pls. Tick) If then Rs. ________________
(TEL.No. with STD code & MOB.No.)

AGE
MOTHERS MAIDEN NAME Y/N Y/N Y/N 'Y'
(TEL.No. with STD code & MOB.No.) If then Rs. ________________
(Pls. Tick) (Pls. Tick) (Pls. Tick)

Year of Passing Medium of

Class / /
% of Instruction
Main Subjects School / College Name Board / University
EDUCATIONAL

Marks (Eng/Hin/Beng/or any

Level PURSUING/
Qualification

other lang)
obtained Pls.Specifty
yet to complete
X
XII
G (F)
PG (F)
Pursuing
•WORKING EXPERIENCE IN YEARSMedical Marketing/Customer Relationship :_______;NON-Medical Marketing/Customer Relationship :________
YEAR
Office / Field
SL.No. Fm To Name of the Company / Firm Place of Work Done Position Held (Pls. Specify)
MM / YYYY MM / YYYY
WORK / JOB
Experience

• LAST Salary drawn (CTC) Rs.______________________P.M ll • EXPECTED Salary (CTC) Rs.______________________________P.M

• Any Part time / Freelance work for earning money, details if any : ___________________________, Earnings PM Rs.__________________
• Attached with Social / Cultural Organisation / NGO's : _____________________________________________________________________
• Any Outstanding Bank/Personal Loan (taken) OR Pending EMI details if any : _____________________________________________________
NAME RELATION DOB AADHAR NO. MOBILE NO.
(Parents / Spouse /

Staying together
FAMILY

Children)

REFERENCES
(Name,Address,Rel

(Closely known to

SL NAME MOBILE NO.

NOMINEE
ation & DOB)

you)

RESIDENTIAL IDENTITY PROOF (Total 2 Nos.) i) ELECTRICITY BILL / TELEPHONE BILL / RATION CARD
(Pls. Attach - Any one out of (i) and also from (ii)) ii) AADHAR CARD / VOTER ID CARD / PANCARD / DRIVING LICENCE
NOTE : I do hereby confirm, if Selected, then shall work, continuously for atleast 2 (two) years. SIGNATURE :
For office
use only

JOINING DATE : POST : TERMS : .

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