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    studyjj21
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    © All Rights Reserved
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    7 views3 pages

    Draft Print

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    studyjj21

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    © All Rights Reserved
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    of 3

    STAFF SELECTION COMMISSION

    REGISTRATION NUMBER : 84000000474

    BASIC DETAILS
    1a. AADHAAR NUMBER -
    1c. AADHAAR ENROLMENT NUMBER -
    1d. TYPE OF ID DRIVING LICENSE
    1e. ID NUMBER OD-3320150149170
    2a. NAME JEEVAN JYOTI BALIARSINGH
    2c. HAVE YOU EVER CHANGED NAME? NO
    2d. NEW NAME -
    3a. FATHER'S NAME KRUSHNA CHANDRA BALIARSINGH
    4a. MOTHER'S NAME GITANJALI BALIARSINGH
    5a. DATE OF BIRTH (DD/MM/YYYY) 20/02/1997
    6. MATRICULATION (10TH CLASS) EXAMINATION DETAILS :
    (i). EDUCATION BOARD COUNCIL FOR THE INDIAN SCHOOL
    CERTIFICATE EXAMINATIONS (ICSE)
    (ii). ROLL NUMBER T23941111
    (iii). YEAR OF PASSING 2012
    7a. GENDER MALE
    8. LEVEL OF EDUCATIONAL QUALIFICATION GRADUATION
    9. MOBILE NUMBER 7205731558
    10. EMAIL ID [email protected]

    ADDITIONAL DETAILS
    11a. CATEGORY UNRESERVED
    12. NATIONALITY CITIZEN OF INDIA
    13. IDENTIFICATION MARKS CUT MARK ON FOREHEAD
    14a. ARE YOU A PERSON WITH DISABILITY? (40% OR NO
    MORE)?

    14b. TYPE OF DISABILITY -


    14c. DISABILITY CERTIFICATE NUMBER -

    14d. UPLOADED DISABILITY CERTIFICATE

    DRAFT PRINT TAKEN ON 23/10/2018 11:40:17 AM


    CONTACT DETAILS
    15a. PERMANENT ADDRESS LC-136/1, PHASE-II, SAILASHREE VIHAR,
    CHANDRASEKHAR PUR
    15b. STATE/ UT ODISHA
    15c. DISTRICT KHORDHA
    15d. PIN CODE 751021
    16. IS PERMANENT ADDRESS SAME AS PRESENT YES
    ADDRESS?

    17a. PRESENT ADDRESS LC-136/1, PHASE-II, SAILASHREE VIHAR,


    CHANDRASEKHAR PUR
    17b. STATE/ UT ODISHA

    17c. DISTRICT KHORDHA


    17d. PIN CODE 751021
    18. CONTACT DETAILS FOR OTHER NATIONALS -

    PHOTO, SIGNATURE AND BIOMETRIC IMPRESSION

    19. UPLOADED PHOTO

    20. UPLOADED SIGNATURE

    21. UPLOADED LEFT HAND THUMB IMPRESSION (LTI)/


    BIOMETRIC IMPRESSION

    22. IF LTI IS NOT AVAILABLE DUE TO DISABILITY,


    BIOMETRIC IMPRESSION OF RIGHT THUMB
    IMPRESSION/LEFT GREAT TOE/RIGHT GREAT TOE

    NOTE
    THIS IS A DRAFT VIEW OF YOUR REGISTRATION.REGISTRATION PROCESS IS NOT YET COMPLETE.YOU
    NEED TO DO 'FINAL SUBMIT' WITHIN 7 (SEVEN) DAYS OF GENERATION OF YOUR REGISTRATION NUMBER,
    FAILING WHICH, YOUR REGISTRATION DATA WILL GET DELETED AUTOMATICALLY.

    DRAFT PRINT TAKEN ON 23/10/2018 11:40:17 AM


    DRAFT PRINT TAKEN ON 23/10/2018 11:40:17 AM

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