2/3/2019 Medical Teacher Application

APPLICATION FOR CONTRACTUAL APPOINTMENT AS TEACHER/SR/TUTOR IN MEDICAL COLLEGES OF STATE

Basic Details
Registration No. CR201901903 Aadhaar No. 267614475911
Name of Post ASSISTANT PROFESSOR Department MEDICINE
Name SUMIT KUMAR
Mother's Name RAGINI DEVI Father's Name SUNIL KUMAR
Date of Birth 06-08-1986 Age 31 Years 11 Month(s)
Gender MALE Marital Status MARRIED
Applicant Belonging To Bihar Health Services (BHS)

Correspondence Address
Location MISCOTT MUHALLA MOTIHARI EAST CHAMPARAN BIHAR State BIHAR
District EAST CHAMPARAN Pincode 845401

Permanent Address
Location MISCOTT MUHALLA MOTIHARI EAST CHAMPARAN BIHAR State BIHAR
District EAST CHAMPARAN Pincode 845401

Contact Details
Email ID TARUNSUMIT@GMAIL.COM Contact No. 8298533337

Other Details
Reservation Category BC Differently Abled No
Has Retired No Retirement Date
Has VRS No VRS Date
Medical Registration Number 40904 Medical Reg. Year 2012
Medical Registration State BIHAR Total no of failures in professional exams 1

Details of Posting
Current Post SENIOR RESIDENT Institute Name GMC BETTIAH
Posted Place BETTIAH Posted State BIHAR
Current Employer BIHAR HEALTH DEPARTMENT
Last Posting SR RESIDENT DHAS DELHI 2nd Last Posting SR RESIDENT AIIMS NEW DELHI

Posting Choices
Choice 1 GMC, BETTIA Choice 2 SKMC&H, MUZAFFARPUR Choice 3 DMC&H, DARBHANGA
Choice 4 PMC&H, PATNA Choice 5 NMC&H, PATNA Choice 6 JNKTMC&H, MADHEPURA
Choice 7 VIMS, PAWAPURI, NALANDA Choice 8 ANMMC&H, GAYA Choice 9 JLNMC&H, BHAGALPUR

Educational Qualification (As per MCI)

Qualification Degree Speciality University Year of Passing Marks Percent (Aggregate)
Graduation MBBS WBUHS KOLKATA 2009 60.85
PG MD MEDICINE AKU PATNA 2014 55.25

Teaching Experience And Publications (As per MCI)

Post From To Period Publications (indexed) Type of Employer
SR/Tutor 14-07-2014 03-02-2019 4 Year(s) 7 Month(s) 5 GOVERNMENT

Declaration by Candidate :- I hereby declare that the information furnished in this application is true to the best of my knowledge. If
any information is found incorrect in this application, either at the time of document verification or at any later stage, my candidature
may be rejected forthwith and I shall be liable for administrative action including termination of contract as well as initiation of
appropriate legal proceedings.

(Candidate's Signature)

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2/3/2019 Medical Teacher Application

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