All India Institute of Medical Sciences

Ansari Nagar, New Delhi - 110608

Recruitment Examination
Application Form - Common Recruitment Examination for AIIMS (CRE-AIIMS)(For Group B & C Posts)

Candidate Profile Candidate ID: 9371031305 Registration No: 9053250 Registration Date: 01/12/2023

Post Applying for:

Junior Administrative Assistant/Lower Divisional Clerk/Jr. Administrative
Assistant(LDC)/Lower Division Clerk

Candidate Name: MAMTA Date of Birth: 20 May 1995

Gender: Female Category: General

Father's Name: GANGA RAM Mother's Name: KANTA DEVI

PWBD Status: No Disability %:NA

Nationality: INDIAN State of Domicile: HIMACHAL PRADESH

Are you a Defence Personnel disabled: No Are you Service Clerks in Armed Forces in
the last year?: No

Are you a Government Employee?: No

Are you a Ex-Service men : No

Contact Details

Address for Permanent: Correspondence Address:

VILLAGE THUNHU , POST OFFICE KALLAR , HP, Bilaspur (Bilaspur- VILLAGE THUNHU , POST OFFICE KALLAR , HP, Bilaspur (Bilaspur- HP) ,
HP) , HIMACHAL PRADESH, India, 174001 HIMACHAL PRADESH, India, 174001

Mobile No: 1. 7018596441 , 2. Alternate-MobileNo 9736159442 E-Mail ID: Manuharshrana@gmail.com

Qualification Details

Qualifying Exam University/Board Name Institute Name Admission Date Passing Date State Name
12th class or equivalent qualification from HPBOSE S D SR SEC SCHOOL SOLAN 20/02/2013 27/11/2014 HIMACHAL PRADESH
a recognized Board or University

Additional Qualification Details

Degree Name Admission Date Passing Date
Diploma in Computer Application 01/05/2012 15/05/2013

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

ID Proof: PAN Card ID No: Edupr5736m Place of Issue: India Issue Date: 15/04/2019 Valid Till: 08/12/2023

Payment Details

Mode: Online Date: 01/12/2023 Transaction ID: 103130510112 Amount: 3000

Do you have experience? : Yes

Organisation Name Designation Start Date End Date

Maharishi Markandeshwar University solan Clerk 01 Apr 2019 30 Jun 2021

AIIMS Bilaspur LDC 05 Jul 2021 01 Dec 2023
Maharishi Markandeshwar University solan Data Entry Operator / Clerk 03 Sep 2015 01 Feb 2019

New Examination City Opted:

State: Exam City(Preference 1): State : Exam City(Preference 2): State : Exam City(Preference 3): Exam City(Preference 4):

Himachal Pradesh Hamirpur Punjab Bathinda Punjab Amritsar Any Other City
Note: Please note that submission of application form does not mean acceptance of application form & candidature, which is always subject to eligibility criteria &
requirement of form such as photo, signature, thumb impression etc. Please visit www.aiimsexams.ac.in after closing date of application regarding date for checking
status of application form.

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. I have also read the advertisement & other information published in this regard
and understand that my candidature is always provisional subject to verification.

Signature of Candidate
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