11/17/23, 11:41 PM Registration Slip 2301755342

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BIHAR STAFF SELECTION COMMISSION

P.O.-VETERINARY COLLEGE, PATNA - 800014
ADVERTISEMENT NO. 02/2023
SECOND INTER LEVEL COMBINED COMPETITIVE EXAM-2023
PERSONAL DETAILS
REGISTRATION NO.: 2301755342
FORM NO. : 3301755342
NAME OF APPLICANT : ANTIMA KUMARI
FATHER'S NAME : PARAMESHWAR NONIYA
MOTHER'S NAME : GAURI DEVI
GENDER : FEMALE
MOBILE NO. : 7318857541
EMAIL ID : ANTIMAKUMARI009@GMAIL.COM
DATE OF BIRTH : 16-09-1996 LIVE PHOTO

AGE AS ON 01-08-2023 : 26 YEARS, 10 MONTHS, 16 DAYS

NATIONALITY : INDIAN
CATEGORY : EBC
DO YOU BELONG TO NON-CREAMY LAYER ? : NO
DOMICILE OF BIHAR STATE : YES
ISSUE DATE OF DOMICILE CERTIFICATE: 07-11-2022
ISSUE NUMBER OF DOMICILE CERTIFICATE : BBCCO/2022/12287545
DOMICILE CERTIFICATE ISSUING OTHER COMPETENT
RO
AUTHORITY :
ARE YOU PERSON WITH DISABILITY? : NO PHOTO

SIGNATURE IN ENGLISH

SIGNATURE IN HINDI

DO YOU HAVE AADHAR CARD? : YES (AADHAR CARD NUMBER: 726197050042)

ID PROOF : AADHAAR CARD ID PROOF NO : 726197050042
BIHAR GOVERNMENT EMPLOYEE WHO HAS RENDERED NOT LESS THAN 3 YEARS
NO
REGULAR AND CONTINUOUS SERVICE? :
WHICH ATTEMPT IS OF INTER LEVEL EXAMINATION? : 01
IDENTIFICATION MARK OF THE CANDIDATE : CUT MARK IN RIGHT HAND
ARE YOU AN EX-SERVICEMAN? : NO
WARD OF FREEDOM FIGHTER? : NO
HAVE YOU EVER BEEN DEBARRED FROM ANY COMPETITIVE EXAMINATION
NO
(UPSC/BOARD/STATE COMMISSION/ANY OTHER)? :
WORKED/WORKING AS CONTRACTUAL EMPLOYEE IN BIHAR GOVERNMENT: NO
ADDRESS DETAILS

CORRESPONDENCE ADDRESS PERMANENT ADDRESS

ADDRESS: SAAWAN KHAIRAMA ADDRESS: SAAWAN KHAIRAMA

VILLAGE/MOHALLA: SAAWAN KHAIRAMA VILLAGE/MOHALLA: SAAWAN KHAIRAMA

POST OFFICE: SAAWAN KHAIRAMA POST OFFICE: SAAWAN KHAIRAMA
POLICE STATION: TETRAHAT POLICE STATION: TETRAHAT
DISTRICT: LAKHISARAI DISTRICT: LAKHISARAI
STATE: BIHAR STATE: BIHAR

PIN CODE: 811311 PIN CODE: 811311

EDUCATIONAL QUALIFICATIONS
EDUCATION SUBJECT BOARD / TOTAL MARKS PERCENTAGE PASSINGDATE CERTIFICATE
UNIVERSITY / MARKS OBTAINED NUMBER

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11/17/23, 11:41 PM Registration Slip 2301755342
INSTITUTE
HINDI ENGLISH JHARKHAND
MATHEMATICS ACADEMIC
10TH / EQUIVALENT 500 255 51.00 16-09-1996 121447
SCIENCEANDTECHNOLOGY COUNCIL
SOCIALSCIENCE SANSKRIT RANCHI
ENGLISH HINDI HISTORY JHARKHAND
12TH / EQUIVALENT
ECONOMICS ACADEMIC
12TH/INTERMEDIATE 500 237 47.40 28-05-2013 061129
POLITICALSCIENCE COUNCIL
(ARTS)
PHILOSOPHY RANCHI
TECHNICAL SKILL
HAVE YOU DONE ANY COMPUTER COURSE? NO
PAYMENT DETAILS:
PAYMENT BANK : SBI
TRANSACTION ID : 8786182457826
TRANSACTION DATE : 2023-11-17 23:13:57
REGISTRATION FEE (RS.) : 135
DECLARATION DETAILS:
I HEREBY DECLARE THAT THE INFORMATIONS FILLED UP ABOVE BY ME ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I ALSO
DECLARE THAT I HAVE FILLED UP ONLY ONE APPLICATION FORM. I ALSO UNDERTAKE THAT IF ANY INFORMATION IS FOUND OTHERWISE, I
SHALL BE LIABLE FOR ANY LEGAL ACTION AND CANCELLATION OF MY CANDIDATURE.
DATE : 17-11-2023 23:41:05
PLACE: BIHAR
DECLARATION ACCEPTED : YES

NOTE: PLEASE KEEP YOUR REGISTRATION NO.,PASSWORD,MOBILE NO AND EMAIL-ID CAREFULLY FOR FURTHER REFERENCE.

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