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ALL INDIA INSTITUTE OF MEDICAL SCIENCES,BHOPAL,MADHYA

PRADESH

Your Application Number : AIIMSBPL11095

Advt No. : ADM-2(2)/AIIMS/Bhopal/Rectt.Cell/Direct/2022/01

Posted Date : 14/05/2022

Closing Date : 31/07/2022

Sr.no Category Post Applied For Fee

1 Non Faculty Tutor/Clinical Instructor 1000.00

Total Fees 1000.00

(1). Personal Information

1 Name TIPSY ANTONY

2 Father Name ANTONY CL

3 Mother Name LISSY ANTONY

4 Gender Female

5 Category General

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6 Pwd Reservation NO

7 Ex-Servicemen/Govt. yes_ser
Servent

8 Type of Disability NA

9 Percentage of NA
Disability

10 Date of Birth 1990-06-05

11 Age Relaxation no

12 Nationality Indian

13 Religion Christian

14 Merital status Married

15 Spouse Name NITIN GEORGE

16 Contact No 9718357088

17 Alternate Contact No 8010872630

18 Email tipsyantonynis@gmail.com

19 MCI Registration No 48472

20 Valid upto 2023-09-23

21 Communication B-402 NEW KANCHANJUNGA APPT,PLOT 1, SEC 23 DWARKA,NEW

Address DELHI PIN 110077

22 State National Capital Territory of Delhi

23 District North West Delhi

24 Country India

25 Police Station SEC 23 DWARKA POLICE STATION

26 Pin Code 110077

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27 Permanent Address B-402 NEW KANCHANJUNGA APPT,PLOT 1, SEC 23 DWARKA,NEW

DELHI PIN 110077

(2). Educational Qualification Details

University/ Modes Course

Course Name of Institute of Started
Sr. Name Specialization/Subject University/Institute State Course Date

1 10th ENGLISH SJCGHS Kerala Full 2004-

,HINDI,SCIENCE,SOCIAL KARUVANNUR Time 06-01
SCIENCE ,MATHS

2 12th ENGLISH HINDI ST MARYS HSS Kerala Full 2005-

SCIENCE MATHS IRINJALAKUDA Time 05-01

(3). Under Graduation Details

University/ Modes Course

Course Name of Institute of Started
Sr. Name Specialization/Subject University/Institute State Course Date

1 BSC B.Sc Nursing AIIMS DELHI National Full 2009-

HONS Capital Time 08-01
NURSING Territory of
Delhi

(4). Post Graduation Details

University/ Modes Course

Course Name of Institute of Started
Sr. Name Specialization/Subject University/Institute State Course Date

1 MSC Post Graduate Degree AIIMS DELHI National Full 2019-

NURSING Capital Time 08-01
(CRITICAL Territory of
CARE ) Delhi

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(5). Superspecialization Details

University/ Modes Course

Course Name of Institute of Started
Sr. Name Specialization/Subject University/Institute State Course Date

(6). PHD Details

University/ Modes Course

Course Name of Institute of Started
Sr. Name Specialization/Subject University/Institute State Course Date

(7). Any Other Qualifications

University/ Modes Course

Course Name of Institute of Started
Sr. Name Specialization/Subject University/Institute State Course Date

(8). Awards Details

Sr During Which Course Year Awarding Body Description

(9). Publications Details

Sr Number Name

(10). Work / Training / Research Experience Details (Past to

Present)

Organisation Nature of Organisation Date Date No. of

Sr. Name & City Designation work Type (From) (To) Years

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Organisation Nature of Organisation Date Date No. of

Sr. Name & City Designation work Type (From) (To) Years

1 AIIMS DELHI NURSING CLINICAL Government 2014- 2022- 8 years,

OFFICER 03-03 07-16 4
months,
16 days

(11). NOC (No Objection Certificate) Details

NOC Details

I am not Serving in any Government Organization ,so I do not need to submit NOC : no

I am Serving in a Government Organization, and I will upload NOC : yes

I am Serving in a Government Organization, and I will upload Vigllance Certificate : no

I have applied for NOC or Vigllance Certificate, I will bring it at the time of interview : yes

(12). Uploaded Document Details

Educational Qualification 10th Certificate : YES

Educational Qualification 12th Certificate : YES

Under Graduation Certificate : YES

Diploma Details Certificate : NA

Post Graduation Certificate : YES

Superspecialization Certificate : NA

PHD Details Certificate : NA

Any Other Qualifications Certificate : NA

Experience Certificate : YES

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NOC (No Objection Certificate) Certificate : yes

Cast Certificate : NA

(13). Declaration

Declaration by Candidate :-

I hereby declare that all the information stated above in this application form are
true, complete and correct to the best of my knowledge and belief. In the event of
any information being found false or incorrect, I hereby convey my consent for
cancellation of my candidature and may be forfeited.

(14). Payment Details

Payment Status : DONE

Amount : 1000.00

Payment Id : 111571571937

Payment Date : 2022-07-16 17:59:01

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