STAFF SELECTION COMMISSION

REGISTRATION NUMBER : 40001035534

BASIC DETAILS
1a. AADHAAR NUMBER 500708856542
1b. TYPE OF ID -
1c. ID NUMBER
2a. NAME DEBRAJ GHOSH
2c. HAVE YOU EVER CHANGED NAME? NO
2d. NEW NAME -
3a. FATHER'S NAME PRATAP CHANDRA GHOSH
4a. MOTHER'S NAME RINA GHOSH
5a. DATE OF BIRTH (DD/MM/YYYY) 06/02/2001
6. MATRICULATION (10TH CLASS) EXAMINATION DETAILS :
(i). EDUCATION BOARD WEST BENGAL BOARD OF SECONDARY
EDUCATION
(ii). ROLL NUMBER 604761N-0207
(iii). YEAR OF PASSING 2017
7a. GENDER MALE
8. LEVEL OF EDUCATIONAL QUALIFICATION HIGHER SECONDARY (10+2)
9. MOBILE NUMBER 8293636830
10. EMAIL ID ghoshdebraj710@gmail.com

ADDITIONAL DETAILS

11a. CATEGORY OBC

12. NATIONALITY CITIZEN OF INDIA

13. IDENTIFICATION MARKS CURVED TEETH

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

MORE)?

14b. TYPE OF DISABILITY -

14c. DISABILITY CERTIFICATE NUMBER -

CONTACT DETAILS
15a. PERMANENT ADDRESS PANDUA
15b. STATE/ UT WEST BENGAL

DRAFT PRINT TAKEN ON 24/11/2019 9:12:13 AM

15c. DISTRICT HOOGHLY
15d. PIN CODE 712149
16. IS PERMANENT ADDRESS SAME AS PRESENT YES
ADDRESS?

17a. PRESENT ADDRESS PANDUA

17b. STATE/ UT WEST BENGAL

17c. DISTRICT HOOGHLY

17d. PIN CODE 712149
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 24/11/2019 9:12:14 AM