Common Written Examination for Recruitment of Probationary Officers/ Management Trainees in 19 Public Sector Ban

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Registration #: Category : If Person with Disability : Full Name: Type of Disability : Percentage of Disability : Do you intend to use the services of a scribe(only for VI and OC candidates whose writing speed has been affected by cerebral palsy) : Whether Children/Family Members of those who died in 1984 Riots? : Whether domiciled in Kashmir Division of the State of J&K during the period 1-1-1980 to 31-12-1989? Whether you belong to Religious Minority Community? : Religious Minority Community to which you belong : Are you an Ex-Serviceman : Nationality / Citizenship : State/ UT which the Centre of Examination Belongs: State code : Centre of Examination Centre code : Application Fee / Intimation Charges : Payment Mode : NEFT UTR No : Sending Bank Name : City : Deposit Date : Amount : Personal Details : Date of Birth : Age as on on 01.07.2011. : Gender : Husband's Name / Father's Name : Mother's Name : Address for Correspondence :

1001225686 GENERAL NO Megha Verma --NA NO NO NO -NO Indian New Delhi 35 New Delhi 80 NEFT PVNBH11210037108 PUNJAB NATIONAL BANK JAIPUR NEW SANGANER ROAD 29-07-2011 450

Are you an Employee who has completed 5 years of service in RRBs ? : NO

05-09-1986 24 FEMALE L.R.Verma Shyama Verma Plot No. 42 Ram Nagar-F Swez Farm Saudala

State : Pin : Permanent Address :

RAJASTHAN 302019 1273 Sector-4 Urban Estate