STAFF SELECTION COMMISSION

REGISTRATION NUMBER : 10001333410

BASIC DETAILS
1a. AADHAAR NUMBER 828860580489
1b. TYPE OF ID -
1c. ID NUMBER
2a. NAME JAGATHEESWARAN
2c. HAVE YOU EVER CHANGED NAME? NO
2d. NEW NAME -
3a. FATHER'S NAME SUBBURAJ
4a. MOTHER'S NAME GURUVAMMAL
5a. DATE OF BIRTH (DD/MM/YYYY) 18/05/1990
6. MATRICULATION (10TH CLASS) EXAMINATION DETAILS :
(i). EDUCATION BOARD TAMIL NADU BOARD OF SECONDARY
EDUCATION
(ii). ROLL NUMBER 2123220
(iii). YEAR OF PASSING 2005
7a. GENDER MALE
8. LEVEL OF EDUCATIONAL QUALIFICATION GRADUATION
9. MOBILE NUMBER 9655231194
10. EMAIL ID jagan.chem531@gmail.com

ADDITIONAL DETAILS

11a. CATEGORY OBC

12. NATIONALITY CITIZEN OF INDIA

13. IDENTIFICATION MARKS MOLE ON RIGHT SIDE SHOULDER

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

MORE)?

14b. TYPE OF DISABILITY -

14c. DISABILITY CERTIFICATE NUMBER -

CONTACT DETAILS
15a. PERMANENT ADDRESS 2/741 PERIYAR NAGAR VISWANATHAM
SIVAKASI
15b. STATE/ UT TAMIL NADU

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15c. DISTRICT VIRUDHUNAGAR
15d. PIN CODE 626189
16. IS PERMANENT ADDRESS SAME AS PRESENT YES
ADDRESS?

17a. PRESENT ADDRESS 2/741 PERIYAR NAGAR VISWANATHAM

SIVAKASI
17b. STATE/ UT TAMIL NADU

17c. DISTRICT VIRUDHUNAGAR

17d. PIN CODE 626189
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 21/12/2019 11:35:49 AM

DRAFT PRINT TAKEN ON 21/12/2019 11:35:49 AM