STAFF SELECTION COMMISSION

REGISTRATION NUMBER : 10001624535

BASIC DETAILS
1a. AADHAAR NUMBER 842767578101
1b. TYPE OF ID -
1c. ID NUMBER
2a. NAME SIVAMANIKANDAN M
2c. HAVE YOU EVER CHANGED NAME? NO
2d. NEW NAME -
3a. FATHER'S NAME MURUGAN K
4a. MOTHER'S NAME SULOCHANA B
5a. DATE OF BIRTH (DD/MM/YYYY) 21/08/1998
6. MATRICULATION (10TH CLASS) EXAMINATION DETAILS :
(i). EDUCATION BOARD KERALA BOARD OF PUBLIC EXAMINATIONS
(ii). ROLL NUMBER 327703
(iii). YEAR OF PASSING 2014
7a. GENDER MALE
8. LEVEL OF EDUCATIONAL QUALIFICATION HIGHER SECONDARY (10+2)
9. MOBILE NUMBER 7034038306
10. EMAIL ID sivamanikandannky@gmail.com

ADDITIONAL DETAILS

11a. CATEGORY ST

12. NATIONALITY CITIZEN OF INDIA

13. IDENTIFICATION MARKS A BLACK MOLE ABOVE THE LEFT FOREHEAD

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

MORE)?

14b. TYPE OF DISABILITY -

14c. DISABILITY CERTIFICATE NUMBER -

CONTACT DETAILS
15a. PERMANENT ADDRESS SIVA NIVAS NAKKUPPATHI KAVUNDIKKAL PO
PIN 678581 PALAKKAD
15b. STATE/ UT KERALA

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15c. DISTRICT PALAKKAD
15d. PIN CODE 678581
16. IS PERMANENT ADDRESS SAME AS PRESENT YES
ADDRESS?

17a. PRESENT ADDRESS SIVA NIVAS NAKKUPPATHI KAVUNDIKKAL PO

PIN 678581 PALAKKAD
17b. STATE/ UT KERALA

17c. DISTRICT PALAKKAD

17d. PIN CODE 678581
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 12/01/2020 10:45:02 PM

DRAFT PRINT TAKEN ON 12/01/2020 10:45:02 PM