8/20/22, 5:47 PM https://norcet2022.aiimsexams.ac.

in/RegistrationSlip

All India Institute of Medical Sciences

Ansari Nagar, New Delhi - 110608
APPLICATION FORM - Nursing Officer Recruitment Common Eligibility Test (NORCET) - 2022

Candidate Profile Candidate ID:

6041176654 Registration No:
52063584 Registration Date:
09/08/2022

Candidate Name:
BINA TIRKEY Date of Birth:
04 Dec 1990

Gender:
Female Category:
ST

Father's Name:
DHADHU MUNDA Mother's Name:
LALO DEVI

Persons with Benchmark Disability Status:

No PWBD Category:
NA

Nationality:
INDIAN State of Domicile:
JHARKHAND

Applied for :
Nursing Officer Recruitment Common Eligibility Test (NORCET) - 2022

Are you a Government Employee : No

Are you a Ex-Service men : No

Contact Details

Address for Permanent: Correspondence Address:

PATRA TOLI , KANKE, P.S- KANKE , POST- RVC KANKE, Kanke , PATRA TOLI , KANKE, P.S- KANKE , POST- RVC KANKE, Kanke ,
JHARKHAND, India, 834006 JHARKHAND, India, 834006

Mobile No: 1.
7631205930
,        2.
Alternate-MobileNo
8210267379 E-Mail ID:
binat72@gmail.com

Qualification Details

Qualifying Exam University Name Collage Name Admission Passing

Date Date

B.Sc (Post-Certificate) / Post-Basic B.Sc Nursing from an Indian Nursing RANCHI SHINE COLLEGE 01/10/2014 20/06/2017
Council recognized Institute or University -- Passed UNIVERSITY OF NURSING
RANCHI

Registration Number with Nursing Council of India/State Nursing Council

Registered as Registration No:(Nurse) Registration No.: (Midwife) State Name of Nursing Council: Issuing Date of Registration:

Nurse and Midwife N- 2107 N- 2107 JHARKHAND 03/12/2018

Valid Photo Identity (To be presented in original at the Examination Center along
with Admit Card)

ID Proof:
Adhar Card ID No:
729143054700 Place of Issue:
INDIA Issue Date:
NA Valid Till:
NA

Payment Details

Mode:
Online Date:
18/08/2022 Transaction ID:
11766541016 Amount:
2400

Do you have experience : No

Examination City Opted:

State: Exam City (Preference 1): State : Exam City (Preference 2): State : Exam City (Preference 3):
JHARKHAND RANCHI JHARKHAND JAMSHEDPUR JHARKHAND DHANBAD

UNDERTAKING/DECLARATION: I hereby declare that the information furnished by me in the Registration/Application Form is correct and nothing has been
concealed. In case any information furnished by me is found to be false/incorrect/untrue than i shall be liable to civil/criminal prosecution and my claim to
admission/appointment/registration/ service in the Institute may be cancelled/terminated.

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Signature of Candidate
Thumb of Candidate

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