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STAFF SELECTION COMMISSION

REGISTRATION NUMBER : 94000734839


BASIC DETAILS
1a. AADHAAR NUMBER 685784749843
1b. TYPE OF ID -
1c. ID NUMBER -
2a. NAME LAXMIPRIYA PARIDA
2c. HAVE YOU EVER CHANGED NAME? NO
2d. NEW NAME -
3a. FATHER'S NAME PRAFULLA PARIDA
4a. MOTHER'S NAME SACHALA PARIDA
5a. DATE OF BIRTH (DD/MM/YYYY) 03/06/1998
6. MATRICULATION (10TH CLASS) EXAMINATION DETAILS :
(i). EDUCATION BOARD BOARD OF SECONDARY EDUCATION, ODISHA
(ii). ROLL NUMBER 053ba023
(iii). YEAR OF PASSING 2014
7a. GENDER FEMALE
8. LEVEL OF EDUCATIONAL QUALIFICATION HIGHER SECONDARY (10+2)
9. MOBILE NUMBER 7077300650
10. EMAIL ID ashutoshparida73@gmail.com

ADDITIONAL DETAILS

11a. CATEGORY UNRESERVED

12. NATIONALITY CITIZEN OF INDIA

13. IDENTIFICATION MARKS BLACK MOLE IN LEFT HAND FINGER

14a. ARE YOU A PERSON WITH DISABILITY? (40% OR NO


MORE)?

14b. TYPE OF DISABILITY -

14c. DISABILITY CERTIFICATE NUMBER -

CONTACT DETAILS
15a. PERMANENT ADDRESS JAGADALPUR DELANGA DELANGA PURI
15b. STATE/ UT ODISHA
15c. DISTRICT PURI

DRAFT PRINT TAKEN ON 03/04/2019 10:10:31 PM


15d. PIN CODE 752015
16. IS PERMANENT ADDRESS SAME AS PRESENT YES
ADDRESS?

17a. PRESENT ADDRESS JAGADALPUR DELANGA DELANGA PURI


17b. STATE/ UT ODISHA

17c. DISTRICT PURI


17d. PIN CODE 752015
18. CONTACT DETAILS FOR OTHER NATIONALS -
PHOTO AND SIGNATURE

19. UPLOADED PHOTO

20. UPLOADED SIGNATURE

NOTE
THIS IS A DRAFT VIEW OF YOUR REGISTRATION.REGISTRATION PROCESS IS NOT YET COMPLETE.YOU
NEED TO DO 'FINAL SUBMIT' WITHIN 14 (FOURTEEN) DAYS OF GENERATION OF YOUR REGISTRATION
NUMBER, FAILING WHICH, YOUR REGISTRATION DATA WILL GET DELETED AUTOMATICALLY.

DRAFT PRINT TAKEN ON 03/04/2019 10:10:36 PM