APPLICATION FORM

Personal Details

Registration Number 81326417

Post Name CONSTABLE

Applicant's First Name LAXMI KUMARI

Last Name SHAW

Applicant's Full Name LAXMI KUMARI SHAW

Date of Birth (DD-MM-YYYY) 02-01-1997

Father's Name SANJAY SHAW

Mother's Name INDU SHAW

Gender FEMALE

Mobile Number 7074501466

Aadhaar No. 736390363281

E-Mail ID laxmishaw942@gmail.com

Nationality INDIAN

Visible Identification Mark 1 CUT MARK ON CHIN

Visible Identification Mark 2 BURN MARK ON RIGHT LEG

Option for Language Paper II HINDI

Maritial Status UNMARRIED

Spouse Name/Others

Other Information
Vacancy Type BOTH

Are you local resedent of Jharkhand NO

Categoty UR

Educational Qualification
EDUCATIONAL MONTH & YEAR OF RESULT ROLL % of Marks
BOARD NAME
QUALIFICATION PASSING STATUS NUMBER Obtained
WEST BENGAL BOARD OF
10th/Matriculation 05-2016 PASS 301132B0037 50.71
SECONDARY EDUCATION

Correspondence address
Address Line 1 AT NEAMATPUR NEAR BANK OF INDIA

Address Line 2 PO SITARAMPUR

City/Village/Town ASANSOL

State/Union Territory WEST BENGAL

Other State District Name PASCHIM BARDHAMAN

Pin code 713359

Permanent address
Address Line 1 AT NEAMATPUR NEAR BANK OF INDIA

Address Line 2 PO SITARAMPUR

City/Village/Town ASANSOL

State/Union Territory WEST BENGAL

Other State District Name PASCHIM BARDHAMAN

Pin code 713359

District wise Preference Details

Vacancy Type District Name Preference

REGULAR DHANBAD 1

REGULAR BOKORO 2

REGULAR RANCHI 3

REGULAR KHOONTI 4

REGULAR HAZARIBAGH 5

REGULAR KODERMA 6

REGULAR GIRIDIH 7

REGULAR RAMGARH 8

REGULAR CHATRA 9

REGULAR SIMDEGA 10

REGULAR GUMLA 11

REGULAR PALAMU 12

REGULAR LATEHAR 13

REGULAR DUMKA 14

REGULAR JAMTADA 15

REGULAR DEOGHAR 16

REGULAR GODDA 17

REGULAR SAHEBGANJ 18

REGULAR WESTERN SINGHBHOOM 19

REGULAR SARAIKELA KHARSAAWAN 20

REGULAR JAPTC 21

REGULAR RAIL DNB 22

REGULAR JWFS 23

REGULAR CTC 24

REGULAR RAIL JSR 25

Payment Details
Transaction Number Amount Transaction Date

113160280404 100 2024-01-30 12:24:50

Declaration
I hereby declare that all statements made in this application are true, complete and correct to the best of my knowledge and belief. I understand
that in the event of any information being found false at any stage or not satisfying the eligibility criteria according to the requirements of the post,
my candidature/ appointment is liable to be cancelled/terminated.

Candidates are advised to take a print of his/her application form and keep-it with him/her along with electronically generated bank receipt in
support of payment of his/her examination fee for future communication in this regard.
System IP : 152.58.190.201
Application Print Date : 30/01/2024 12:26:34 PM