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BIO DATA TO ____________________________ ____________________________ ____________________________

APPLICATION FOR THE POST OF______________________________________ Name Fathers Name Sex Marital Status Address Present Permanent : RATNAKAR SAMANTARY : Krushnachabdra Samantary : Male : Un Married : Ratnakar Samantary At- Ramachandra Pur Po- Dura, Dist- Ganjam : Ratnakar Samantary At- Ramachandra Pur Po- Dura, Dist- Ganjam Via- Berhampour-10 : General : 15/07/1982 : Indian : Hindu

Cast Date of Birth Nationality Religion

Language known : Oriya, English, Hindi Educational Qualification: Examination Board/ Year of Total % of Subject Taken Passed University Passing Mark mark H.S.C B.S.F.O. 1998 302 40.2 ORIYA, ENG., HIN., MTA, MTG, +2 Arts B.A. Pass C.H.E.O. BBSR Berhampur University 2002 2005 402 649 44.6 46.35

SCP, SCL, SSH, SSG ENG, MIL, POL.SC., HISTORY, EDUCATION, EDUCATION (PRAC) ENG, MIL, ENVIROMENTAL STYDIES, EDU PAPER-3, PRACTICAL PAPER-4

Extra Curricular Activities : Community Polytechnic, U.C.P. Engg. School Berhampur ( GM) Orissa Name of the Employment Exchange : Berhampur Registration No. and Date : C/711/09 DECLARATION I do hereby declare that the facts stated above are true and correct to the best of my knowledge and believe Place : Berhampur Date: Signature of the Candidate

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