12/4/23, 1:46 PM Registration Slip 2302252966

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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.: 2302252966
FORM NO. : 3302252966
NAME OF APPLICANT : POOJA KUMARI
FATHER'S NAME : NIRAJ KUMAR MISHRA
MOTHER'S NAME : NILU DEVI
GENDER : FEMALE
MOBILE NO. : 7644952339
EMAIL ID : P4POOJA549@GMAIL.COM
DATE OF BIRTH : 12-10-2003 LIVE PHOTO

AGE AS ON 01-08-2023 : 19 YEARS, 9 MONTHS, 20 DAYS

NATIONALITY : INDIAN
CATEGORY : GEN
DO YOU BELONG TO EWS? : YES
(EBC/BC-NCLC CERTIFICATE NUMBER) / (SC/ST-CASTE
EWSCO/2023/843191
CERTIFICATE NUMBER) / (EWS-CERTIFICATE NUMBER) :
ISSUE DATE OF CERTIFICATE : 21-11-2023
CERTIFICATE ISSUING AUTHORITY : CO
DOMICILE OF BIHAR STATE : YES
ISSUE DATE OF DOMICILE CERTIFICATE: 16-10-2023 PHOTO

ISSUE NUMBER OF DOMICILE CERTIFICATE : BRCCO/2023/10215244

DOMICILE CERTIFICATE ISSUING OTHER COMPETENT
CO
AUTHORITY :
SIGNATURE IN ENGLISH
ARE YOU PERSON WITH DISABILITY? : NO

SIGNATURE IN HINDI

DO YOU HAVE AADHAR CARD? : YES (AADHAR CARD NUMBER: 276189458910)

ID PROOF : AADHAAR CARD ID PROOF NO : 276189458910
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 : MARK ON FORHEAD
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

RAGHOPUR, NARSANDA,KUMAR RAGHOPUR, NARSANDA,KUMAR
ADDRESS: ADDRESS:
BAJITPUR ,PATEPUR,VAISHALI,BIHAR BAJITPUR ,PATEPUR,VAISHALI,BIHAR
VILLAGE/MOHALLA: RAGHOPUR NARSANDA VILLAGE/MOHALLA: RAGHOPUR NARSANDA
POST OFFICE: KUMAR BAJITPUR POST OFFICE: KUMAR BAJITPUR
POLICE STATION: PATEPUR POLICE STATION: PATEPUR

DISTRICT: VAISHALI DISTRICT: VAISHALI

STATE: BIHAR STATE: BIHAR
PIN CODE: 843110 PIN CODE: 843110
EDUCATIONAL QUALIFICATIONS

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12/4/23, 1:46 PM Registration Slip 2302252966
EDUCATION SUBJECT BOARD / TOTAL MARKS PERCENTAGE PASSINGDATE CERTIFICATE
UNIVERSITY / MARKS OBTAINED NUMBER
INSTITUTE
HINDI SANSKRIT
BIHAR SCHOOL
MATHEMATICS
10TH / EQUIVALENT EXAMINATION 500 322 64.40 06-04-2019 530057343
SCIENCE SOCIAL
BOARD
SCIENCE
PHYSICS
12TH / EQUIVALENT BIHAR SCHOOL
CHEMISTRY
12TH/INTERMEDIATE EXAMINATION 500 348 69.60 26-03-2021 1213323088
BIOLOGY HINDI
(SCIENCE) BOARD
ENGLISH
TECHNICAL SKILL
SKILL NAME OF INSTITUTE PASSING DATE CERTIFICATE NUMBER
HINDI TYPING RSR SKILLS AND IT SOLUTION PVT LTD 02-05-2023 23BRVSL0012270583
ENGLISH TYPING RSR SKILLS AND IT SOLUTION PVT LTD 02-05-2023 23BRVSL0012270583
HAVE YOU DONE ANY COMPUTER COURSE? NO
PAYMENT DETAILS:
PAYMENT BANK : SBI
TRANSACTION ID : 0949959699419
TRANSACTION DATE : 2023-12-04 13:14:34
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 : 04-12-2023 13:45:44
PLACE: VAISHALI
DECLARATION ACCEPTED : YES

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

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