http://online.bih.nic.in/LSRec/APP/AppPrint.

aspx

Application Form
Social Welfare Department (ICDS), Govt. of Bihar
Application for Contractual Recruitment of Lady Supervisor
Application Details
Application ID : LSP/0388507 Application Date :
Post Applied For : Lady Supervisor
25-Jul-2019

Personal Details
Applicant Name ANURADHA SINGH
Father's /Husband's Name NAGENDRA SINGH
Mother's Name MIRA DEVI
Date of Birth 11-Jan-1993
Age as on (01.01.2019) 25 Years 11 Months
Gender Female
Marital Status Yes
Category GEN
Nationality Indian
Physically Handicapped No
Catagory of Physically Handicapped
Percentage of Physically Handicapped No
Grand Children of Freedom Fighter No
Email ID pkrahul2015@gmail.com
Mobile No. 7903944023
Phone With STD Code
Aadhar No XXXXXXXX1426
Identification Marks A CUT MARK ON FOREHEAD
Do you know read/write hindi Yes
Do you have minimum qualification as Yes
defined in Advertiesment
Reference of known person with address
who has seen Your Work [Last Six
Month] (1)
Reference of known person with address
who has seen Your Work [Last Six
Month] (2)
If any Criminal Proceedings[Aapradhik No
Mukadama] Against You has been
Initiated ?
Are you Employee of Bihar Govenment No
Designation
Office
Place

Address for Correspondence

Address NAGENDRA SINGH, VILL.-MORDIHRI, PO-PADRAWAN, PS.-JAMHOR, DIST.-
AURANGABAD
Pin Code 824121

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 http://online.bih.nic.in/LSRec/APP/AppPrint.aspx

Permanent Address
Address OM PRAKASH SINGH, VILL.-HAIBATPUR, PO-RAMPUR CHAURAM, PS.-RAMPUR
CHAURAM
Pin Code 804402
State of Domicile Yes
Home District ARWAL

Educational Qualification
Board/University Institute State Specialization Passing Marks
Type Year Obtained
(%)
I.Matric BIHAR SANSKRIT SIKSHA BOARD, PATNA Gevernment Bihar 2014 64.57
II.Intermediate KAMESHWAR SINGH DARBHANGA SANSKRIT Gevernment Bihar Arts 2016 66.1
VISHWAVIDYALAYA
III.Degree DARBHANGA SANSKRIT VISHWAVIDYALAYA Gevernment Bihar Graduate in Any 2019 65
Stream
IV.Post Private 0 0
Graduation

Experience
No Experience Mentioned

Points
Total Point 65.22

I declare that all the above information is correct to the best of my knowledge and that I shall be liable for punishment if information is found
incorrect. I also declare that I have understood the guideline for engagement and will fully abide by the same including any further guideline issued
by ICDS, Government of Bihar in this regard. I categorically declare that there is no pending Criminal case or serious complaint against myself.

Place:-

Date:-
Signature of Applicant

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