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Recruitment For Paramedical Staff

Personal Details

Application DMC0221004323 Transaction Id 21051503363840357567 Payment Payment Done

No Status

Applicant's ARTI SHARMA Father's/Husband's B L SHARMA Mother's SUSHILA SHARMA

Name Name Name

Gender Female Category UR

Nationality Indian Channel ID CITIZEN

Date Of 15/06/1998 Age as on 22Years, 06Months & Email Id arti*****rediffmail.com

Birth(DD/MM 01/01/2021 17Days.
/YYYY)

Are you Yes Are You an Ex Serviceman? No

Domicile of
MP?

Are You Physically Handicapped?(Only Orthopedic Handicapped (45% to 50%) Lower Body No
Disability is Valid.)

Active Registration No Of Madhya Pradesh Pharmacy Council 56069

Marital Status

Marital Status Single Marriage Date (DD/MM/YYYY) -

No.of Children - Last child birth date(DD/MM/YYYY) -

Is Your Last Child Born Twins? -

Other Details

Name of the Post applied for PHARMACIST GRADE-2

Educational Qualification

Qualification Passing Year(YYYY) University/Board Institute/College Name Obtained Percentage (00.00)

10th 2013 CBSE ANAND VIHAR SCHOOL 58.90%

12th(PCB) 2016 MP BOARD SHREE AURBINDO SCHOOL 70.04%

D PHARMA 2018 RGPV BHOPAL S V POLYTECHNIC BHOPAL 60.50%

Other Information

Are You Serving in Government/Corporation/Board/Autonomous Organizations? No

Do you have minimum 6 Months Working Experience PHARMACIST GRADE-2?(If so, the applicant Experience No
Letter is compulsory to attach)?

Have you Worked as Samvida Employee on the Same Post? No

Address Details

Communication Address G 99/25 TULSI NAGAR BHOPAL,MADHYA PRADESH,BHOPAL,462003,,934****099

Permanent Address G 99/25 TULSI NAGAR BHOPAL,MADHYA PRADESH,BHOPAL,462003,,934****099

Bank Details
Receipt https://mponline.gov.in/portal/services/recruit_dmc/showreciept.aspx?da...

Account Number *****9636 Bank Name STATE BANK OF INDIA

Account Holder Name ARTI SHARMA IFSC Code SBIN0030367

Fee Details

Application Fee Rs. 400

Portal Charge Rs. 170

G.S.T(9% SGST and 9% CGST out of 18%) Rs. 30.6

Total Amount Rs. 600.6

MPOnline GSTNO. 23AAECM7539B1ZQ

Photo with Signature

Document Section

SNo Document Name link

1 Qualification Diploma (.jpg upto 200KB) Download

2 10th Marksheet (.jpg upto 200KB) Download

3 12th Marksheet (.jpg upto 200KB) Download

4 MP Domicile Certificate(.jpg upto 200KB) Download

5 Active Registration No Certificate(only in .jpg format upto 200KB) Download

6 Photo Identification Certificate(only in .jpg format upto 200KB) Download

Read form carefully before

submission.
I, HEREBY DECLARE THAT ALL THE INFORMATION GIVEN IN THE AFOREMENTIONED ACCORDING TO POST OF
APPLICATION FORMAT IS TRUE TO THE BEST OF MY KNOWLEDGE. I UNDERTAKE AND ACCEPT THAT IF ANY OF THE
INFORMATION GIVEN BY ME IS FOUND TO BE INCORRECT, THEN MY APPLICATION WILL BE REJECTED AND IF
APPOINTED, THEN MY APPOINTMENT WILL BE TERMINATED & ACTION MAY BE TAKEN ACCORDINGLY.

I HEREBY DECLARE THAT ALL THE INFORMATION GIVEN IN THE AFOREMENTIONED APPLICATION FORMAT IS TRUE TO THE BEST OF
MY KNOWLEDGE. I UNDERTAKE AND ACCEPT THAT IF ANY OF THE INFORMATION GIVEN BY ME IS FOUND TO BE INCORRECT, THEN
MY APPLICATION WILL BE REJECTED AND IF APPOINTED, THEN MY APPOINTMENT WILL BE TERMINATED & ACTION MAY BE TAKEN
ACCORDINGLY.